Melo, Lygia Maria de FigueiredoPinheiro, Marta Maria2021-03-152021-03-152020-11-18PINHEIRO, Marta Maria. Referência e contrarreferência no componente pré-natal da Rede Cegonha no município de Natal/RN. 2020. 162f. Dissertação (Mestrado Profissional em Práticas de Saúde e Educação) - Escola de Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2020.https://repositorio.ufrn.br/handle/123456789/31891In the context of the Unified Health System of Brazil, called Sistema Único de Saúde, aiming to overcome the fragmentation of health care and achieve, among other principles, that of comprehensive care, it is proposed to organize assistance in Brazilian Health Care Networks, known as Redes de Atenção à Saúde. In this sense, the strategy of the Ministry of Health of Rede Cegonha seeks to implement care to ensure quality and humanized care for women in various areas, including prenatal care. Considering that high-risk prenatal care, which is necessary when pregnant women are more likely to have an unfavorable outcome, occurs at different points of care, the integration of these points in ensuring integrality is of fundamental importance. This study aims to analyze the reference and counter-reference of the prenatal component of Rede Cegonha in the city of Natal/RN. It is a qualitative, descriptive and exploratory study. To this end, data collection was performed on reference and counterreference sheets sent to high-risk prenatal care and interviews with professionals in Primary Health Care, Specialized Care, management of the Department of Primary Care, Department of Specialized Care, system regulation and pregnant women attended at a high-risk prenatal care service. The data collected by the chips were analyzed using descriptive statistics with the aided of Excel Software. Atlas.ti (version 8) was used to organize and categorize the interview data and the thematic analysis by Bardin was used as an interpretation method. The following thematic categories were listed: Category 1 - Reference and counter-reference: from the normative function to the potential of network integration, with the Subcategories: understanding of reference and counter-reference as triggering and responding to the Specialized Care; understanding of reference and counter-reference as organization of the network and articulation between levels; Without clarity or with reduced concept of reference and counter-reference. Category 2 - Reference, counter-reference and organization of the stork network: distance between the real and the ideal in the coordination of care and integration of the levels of care, with the subcategories: The daily routine of reference and counter-reference in the Cegonha Network; organization and mechanisms to ensure timely, quality care and network integration; communication in the Cegonha Network and care coordination: the challenge of counter-referral. Category 3 - Mishaps and paths for integration in the stork network: what do we have and what can we do? with the subcategories: the challenge of consolidating the reference and counter-reference in the municipal stork network; what’s powerful about Cegonha Network. The analysis in the reference and counter-reference forms showed flaws in filling them out in the Primary Health Care, absence of return of the counterreference by the Specialized Care and origin of the forms coming from the five health districts, as well as subsidizing the choice of the Primary Health Care units for the collection of the interviews. Based on the theoretical framework of comprehensiveness and integrated health service systems, concepts were approached. The results of the interviews point to communication failures between the services that make up the Prenatal Cegonha Network component, as well as weaknesses in the use of the instruments adopted to integrate the assistance levels such as the reference and counter-reference. It was also possible to find flaws in the assistance protocols, ins additions to the product, a flow chart of the reference and counter-reference analyzer was constructed in the Prenatal component in the Cegonha Network, which can be used by professionals to improve the coordination of care and integrality. Thus, they propose to collaborate for greater theoretical and practical knowledge in the field of integrality and coordination of care, understood as essential in the provision of integral health care.Acesso AbertoCuidado pré-natalRede CegonhaIntegralidade em saúdeAcesso aos serviços de saúdeNíveis de atenção à saúdeReferência e contrarreferênciamasterThesis