Organização da atenção pré-natal na rede regional
Carregando...
Data
2019-02-27
Autores
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A rede de atenção à saúde maternoinfantil foi instituída em 2011 com a finalidade de promover melhorias na eficiência da gestão dos serviços, porém ainda se apresenta como um grande desafio para os gestores. Objetivo: Analisar a rede regional de atenção à saúde da gestante no SUS. Método: Trata-se de pesquisa de caráter transversal, quanti-qualitativa, tipo inquérito. Foram realizadas entrevistas com gestores de 28 municípios, do Ambulatório de Especialidades Médicas (AME) e do Departamento Regional de Saúde (DRS) II do estado de SP, totalizando 86 entrevistados. As variáveis pesquisadas foram: realização de atividade educativa no pré-natal, existência de protocolo de atendimento e encaminhamento, organização da atenção à saúde bucal e geral à gestante, pactuação das referências e funcionalidade do sistema de referência e contrarreferência. Realizou-se análise de conteúdo para as questões discursivas e triangulação entre as respostas obtidas nos municípios, AME e DRS. Resultado: Observou-se que 78,57% dos municípios realizam atividade educativa com gestantes; 42,86% não possuíam protocolo de atendimento implantado e em 57,14% não havia critérios de encaminhamento estabelecidos. Do total de gestores municipais, 53,57% afirmaram realizar testes rápidos para detecção de HIV, Sífilis e Hepatite B e C; 46,43% teste rápido de gravidez e 39,28% relataram avaliar a situação vacinal. Quanto à atenção odontológica primária, não havia protocolo instituído em 71,43% dos municípios e 32,14% não incluíam a gestante no grupo prioritário de atendimento. Há pouca compreensão quanto aos documentos de pactuação, deficiências no sistema de referência e contrarreferências e insuficiência de referências odontológicas. Conclusão: Conclui-se que a rede de atenção à saúde maternoinfantil tem garantido atividades educativas, porém encontra-se pouco articulada entre seus componentes, apresentando deficiências relacionadas ao processo de trabalho e à gestão dos serviços, decorrentes, em sua maioria, da inexistência de protocolos assistenciais e organizacionais.
Introduction: The maternal and child health care network was established in 2011 with the purpose of promoting improvements in the efficiency of service management, but still presents a great challenge for managers. Objective: To analyze the regional health care network of pregnant women in SUS. Method: This is a cross-sectional, quantitative-qualitative research type survey. Interviews were carried out with managers from 28 municipalities, from the Ambulatory of Medical Specialties (AME) and from the Regional Department of Health (DRS) II of the state of São Paulo, totaling 86 interviewees. The variables studied were: performance of prenatal educational activity, existence of a referral protocol, organization of oral and general health care for the pregnant woman, agreement of references and functionality of the referral and counter-referral system. Content analysis was performed for the discursive questions and triangulation between the responses obtained in the municipalities, AME and DRS. Result: It was observed that 78.57% of the municipalities carry out educational activities with pregnant women; 42.86% did not have an implanted care protocol and in 57.14% there were no established referral criteria. Of the total of municipal managers, 53.57% affirmed to carry out rapid tests for the detection of HIV, Syphilis and Hepatitis B and C; 46.43% rapid pregnancy test and 39.28% reported evaluating the vaccine situation. Regarding primary dental care, there was no protocol established in 71.43% of the municipalities and 32.14% did not include the pregnant woman in the priority care group. There is little understanding of compromise documents, deficiencies in the referral system and counter-referrals, and insufficiency of dental referrals. Conclusion: It is concluded that the network of maternal and child health care has guaranteed educational activities, but it is little articulated among its components, presenting deficiencies related to the work process and to the management of services, due, for the most part, to the inexistence of assistance and organizational protocols.
Introduction: The maternal and child health care network was established in 2011 with the purpose of promoting improvements in the efficiency of service management, but still presents a great challenge for managers. Objective: To analyze the regional health care network of pregnant women in SUS. Method: This is a cross-sectional, quantitative-qualitative research type survey. Interviews were carried out with managers from 28 municipalities, from the Ambulatory of Medical Specialties (AME) and from the Regional Department of Health (DRS) II of the state of São Paulo, totaling 86 interviewees. The variables studied were: performance of prenatal educational activity, existence of a referral protocol, organization of oral and general health care for the pregnant woman, agreement of references and functionality of the referral and counter-referral system. Content analysis was performed for the discursive questions and triangulation between the responses obtained in the municipalities, AME and DRS. Result: It was observed that 78.57% of the municipalities carry out educational activities with pregnant women; 42.86% did not have an implanted care protocol and in 57.14% there were no established referral criteria. Of the total of municipal managers, 53.57% affirmed to carry out rapid tests for the detection of HIV, Syphilis and Hepatitis B and C; 46.43% rapid pregnancy test and 39.28% reported evaluating the vaccine situation. Regarding primary dental care, there was no protocol established in 71.43% of the municipalities and 32.14% did not include the pregnant woman in the priority care group. There is little understanding of compromise documents, deficiencies in the referral system and counter-referrals, and insufficiency of dental referrals. Conclusion: It is concluded that the network of maternal and child health care has guaranteed educational activities, but it is little articulated among its components, presenting deficiencies related to the work process and to the management of services, due, for the most part, to the inexistence of assistance and organizational protocols.
Descrição
Palavras-chave
Gestantes, Cuidado pré-natal, Atenção primária à saúde, Sistema único de saúde, Saúde pública, Encaminhamento e consulta, Prenatal care, Primary health care, Single health system, Pregnant women, Public health, Referral and consultation