Avaliação da qualidade da assistência pré-natal no município de Tangará/RN

Abstract

Prenatal care aims to ensure the healthy development of pregnancy and enable the birth of a healthy baby. The quality of this care plays a decisive role in maternal and neonatal mortality. From this perspective, quality assessment processes in health services are necessary and important to identify weaknesses and draw up proposals for decision making by management and professionals. Inserted in this theme, the present study aimed to evaluate the quality of prenatal care in the city of Tangará/RN. This is an evaluative study of the normative and cross-sectional type, with a quanti-qualitative approach, based on semi-structured interviews with 11 professionals from family health units and 21 users who gave birth between the months of October and December 2021. Information was also collected from the systematic observation of the units and from the pregnant women's booklets. Data collection occurred from January to March 2022. In this study, the quality of prenatal care was assessed using an index based on the Donabedian triad "structureprocess-result" that classifies prenatal care into four categories (superior adequate, when there is 100% adequacy; adequate, when adequate items represent 75% or more; intermediate, from 51 to 74% of adequate responses; and inadequate, when 50% or less of the responses are adequate). Data analysis was done using SPSS software and content analysis. The classification of prenatal care was categorized as intermediate for adequacy of prenatal care, showing weaknesses. The components "process" and "results" were the ones that stood out the most in terms of weaknesses. The "structure" component showed weaknesses in ensuring access to basic tests recommended for prenatal care. Regarding the "process", the low coverage of pregnant women meeting the goals of the Prenatal and Birth Humanization Program, the low performance of clinical-obstetric procedures by professionals to assess maternal-fetal health, the low multiprofessional performance, and the low performance of educational activities for pregnant women were observed. The "results" component showed weaknesses in the guidance given to pregnant women, as well as the guarantee, by the service network, of access and accessibility to reference services, in the case of high-risk prenatal care. The weaknesses found by the index based on the triad corroborated the results obtained by the interviews conducted with professionals and users. Therefore, there is an urgent need for these aspects to be considered for the planning and development of actions aimed at maternal and child health, specifically in prenatal care in primary health care, since these aspects interfered directly in the adequacy and quality of usual risk prenatal care in the municipality surveyed.