PERINATAL CARE IN A NORTHEASTERN BRAZILIAN STATE: STRUCTURE, WORK PROCESSES, AND EVALUATION OF THE COMPONENTS OF ESSENTIAL NEWBORN CARE
- PMID: 30810691
- PMCID: PMC6651313
- DOI: 10.1590/1984-0462/;2019;37;2;00003
PERINATAL CARE IN A NORTHEASTERN BRAZILIAN STATE: STRUCTURE, WORK PROCESSES, AND EVALUATION OF THE COMPONENTS OF ESSENTIAL NEWBORN CARE
Abstract
Objective: To describe the structure and the processes of care for pregnant women/newborn infants, including the Essential Newborn Care (ENC), in maternity hospitals in Sergipe State, Brazil.
Methods: A cross-sectional study carried out between June 2015 and April 2016 in all maternity hospitals of Sergipe with more than 500 deliveries/year (n=11). A questionnaire on the existing structure and work processes was administered to the managers. Subsequently, a representative number of postpartum women from these hospitals were interviewed (n=768). Their medical records, as well as newborn infants' records, were also analyzed.
Results: Sergipe has 78 beds of Neonatal Intensive Care Unit (NICU) and 90 beds of Intermediate Care Unit (IMCU) to meet spontaneous and programmed demand. Only six maternity hospitals (54.5%) performed the risk classification, and four (36.3%) had protocols for high-risk parturient care. Regarding the ENC components, only 41% (n=315) of the women had early skin-to-skin contact with their babies, 33.1% (n=254) breastfed in the first hour of life, and 18% (n=138) had a companion always during birth.
Conclusions: The distribution of NICU beds between capital city and other cities of the State is adequate, considering Brazilian guidelines. However, there was a low adherence to the protocols for hypertensive and hemorrhagic emergencies, and a low coverage of humanization policies, pregnancy risk classification and ENC practices, especially breastfeeding in the first hour of life, and companion always during birth.
Objetivo:: Descrever a estrutura e os processos de atendimento a gestante/recém-nascido, incluindo os componentes do Essential Newborn Care (ENC), das maternidades de Sergipe, Brasil.
Métodos:: Estudo transversal realizado entre junho de 2015 e abril de 2016 em todas as maternidades de Sergipe (n=11) com mais de 500 partos/ano. Foi aplicado um questionário aos gestores sobre a estrutura e os processos de trabalhos existentes. Posteriormente, um número representativo de puérperas desses hospitais foi entrevistado (n=768) e seus prontuários, bem como o dos recém-nascidos, foram analisados.
Resultados:: Sergipe conta com 78 leitos de Unidade de Terapia Intensiva Neonatal (UTIN) e 90 de Unidade Intermediária (UI) para atendimento da demanda espontânea e programada. Somente seis maternidades (54,5%) realizam a classificação de risco e quatro (36,3%) possuem protocolos para atendimento das parturientes de alto risco. No que se refere aos componentes do ENC, apenas 41% (n=315) das mulheres tiveram contato pele a pele precoce com seu filho, 33,1% (n=254) amamentaram na primeira hora de vida e 18% (n=138) tiveram a presença do acompanhante em todos os momentos do parto.
Conclusões:: A distribuição de leitos de UTIN entre capital/interior é adequada no Estado, levando-se em consideração a legislação vigente no país. Entretanto, houve baixa adesão aos protocolos das emergências hipertensivas e hemorrágicas, e baixa cobertura das políticas de humanização, da classificação de risco para a gestante e das práticas do ENC, principalmente quanto à amamentação na primeira hora de vida e à presença do acompanhante na parturição.
Conflict of interest statement
Comment in
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PERINATAL CARE IN A NORTHEASTERN BRAZILIAN STATE: STRUCTURE, WORK PROCESSES, AND EVALUATION OF ESSENTIAL NEWBORN CARE COMPONENTSAUTHOR'S RESPONSE LETTERPerinatal care in a northeastern Brazilian state: structure, work processes, and evaluation of the components of essential newborn careHealth facility structure and maternal characteristics related to essential newborn care in Brazil: a cross-sectional studyObstetric care models in the Southern Region of Brazil and associated factors.Rev Paul Pediatr. 2020 Nov 20;39:e2019334. doi: 10.1590/1984-0462/2021/39/2019334. eCollection 2020. Rev Paul Pediatr. 2020. PMID: 33237134 Free PMC article. No abstract available.
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