Nascer no Ceará: avaliação da rede materno-infantil na macrorregião sertão central do Ceará

Abstract

Maternal and child mortality reflect the quality of life of a region, especially the health care provided to the female population. The epidemiological profile of the maternal mortality ratio has been considered as the best indicator of the health of the female population and, consequently, an excellent public policy management tool aimed at reducing the rates presented here. The organization of networked maternal and child care causes changes in the health care model and points to the need to implement new care models. Regionalized and integrated health care networks promote a more adequate structure to effect comprehensive care and the qualification and continuity of health care. The State of Ceará, through the More Childhood Ceará Program and the State Department of Health, in partnership with the Cearense Society of Gynecology and Obstetrics (Socego), wishing to favorably modify this scenario of maternal and perinatal morbidity and mortality, launched the Nascer Program no. Ceará, from the situational analysis of maternal and child care by health macroregion of the state of Ceará. Thus, the present study aims to analyze the health situation of the maternal and child care network regarding the comprehensiveness of care. This is an epidemiological, observational, analytical, cross-sectional study, conducted from data collected from January to December 2017, in the central Sertão macroregion of the state of Ceará. Participated in the study all Health Units of Macrorregião Central Sertão that provide maternal child care, including: primary health care units of 20 municipalities, two regional polyclinics and 15 maternity referral for pregnant women of the macroregion Sertão Central. Data collection included indicators of the reason for mortality and its causes, infant mortality rate and its causes, adolescent pregnancy rate and the variables related to prenatal care, allocated into: structure, process and outcomes. Data referring to epidemiological indicators were requested from the State Department of Health (SESA) epidemiological surveillance and collected by the Health Information Systems (SIS). For analysis of epidemiological indicators we used parameters from the World Health Organization and the Brazilian Ministry of Health. To analyze the indicators of structure, process and results of health units, we used the Ministry of Health rules, such as ordinances, manuals, among others. Results will be categorized and presented as tables and figures. From the perspective of thematic networks, low interaction between network services was indicated, pointing out flaws in the planning of actions and referral to specialized services, reflections of a hegemonic, hospital-centered and disease-centered medical care model. The process of implanting this network requires articulated actions between managers, health professionals and the community, thus the chances of success of these actions will be greater. As this is a secondary data research, it was not necessary to approve the study in the Research Ethics Committee.