Analysis, monitoring and improvement of the pregnant woman's oral health care network.

• Grant number: 23/10269-9
• Support Opportunities: Research Grants - Research in Public Policies
• Start date: February 01, 2024
• End date: January 31, 2027
• Field of knowledge: Health Sciences - Dentistry - Social and Preventive Dentistry
• Principal Investigator: Suzely Adas Saliba Moimaz
• Grantee: Suzely Adas Saliba Moimaz
• Host Institution: Faculdade de Odontologia (FOA). Universidade Estadual Paulista (UNESP). Campus de Araçatuba. Araçatuba , SP, Brazil
• City of the host institution: Araçatuba
• Associated researchers: Fernando Yamamoto Chiba ; Lia Borges de Mattos Custodio ; Nemre Adas Saliba ; Ronald Jefferson Martins ; Tânia Adas Saliba

Abstract

The emergence of chronic diseases demanded from the Brazilian health systemcontinuous and integrated care for its users, differing from fragmented care, whichwas mainly focused on acute illnesses. The Health Care Networks (RAS) thus emergewith the aim of promoting the integration of the care system, and the rationalizationof resources. The Maternal and Child Health Care Network in the SUS, including oralhealth, is still a challenge for managers, due to the existence of difficulties, rangingfrom the user's access to basic care, to the referral to the specialized service. Studieson the evaluation of health care networks are essential, as they can contribute to theadvancement of the implementation process of the Unified Health System-SUS. Thisresearch aims to study prenatal care for high-risk pregnant women, focusing onbreastfeeding and oral health in medium-complexity health services, a reference for 28municipalities in the state of São Paulo. This is a cross-sectional, quantitative andqualitative study, to be carried out in three phases: Phase I - Exploratory; Phase II-Intervention and Phase III- Evaluation. Data will be collected in the health services of28 municipalities in the state of São Paulo and in the Specialty Medical Clinic (AME),on: socio-demographic profile of pregnant women; demand organization in theregional health care network; referral and counter-referral system for services; oralhealth status of high-risk pregnant women and implementation of protocols for dentalcare for high-risk pregnant women. Serão realizados exames bucais de gestantes dealto risco, entrevistas com os gestores e consulta aos sistemas de informação emsaúde. A pesquisa possibilitará obter dados sobre as condições relacionadas a rede deserviços de saúde para os cuidados pré-natais; a integração dos profissionais de saúdedas diferentes áreas para os cuidados da gestante e práticas de AM, bem como asfragilidades e fortalezas da Rede de Atenção Materno-Infantil (RAMI). A partir damodificação do sistema de informação e da abertura da agenda odontológica nosistema, espera-se a consolidação e a garantia da atenção integral pela equipemultiprofissional, no ambulatório para as gestantes de alto-risco. Os resultadosobtidos contribuirão também para a implementação de novas rotinas na assistência àsaúde das usuárias e nas práticas de AM no AME e na FOA-Unesp, pois fornecerãoinformações detalhadas sobre o início e número de consultas pré-natal, principaismotivos de afecções relacionadas à gestação de alto-risco; condições de saúde bucaldurante pré-natal; taxas de adesão ao tratamento odontológico e da consulta depuerpério; intenção de amamentar e fatores relacionados a sua interrupção precoce. Itwill also be possible to obtain information about the referral and counter-referralsystem, criteria and forms of referral to guarantee comprehensive care. All the toolsemployed and the data obtained will be able to help direct the strategic planning ofactions in health services, both in Primary and Specialized Care. Quantitative data willbe submitted to appropriate statistical analysis, at a significance level of 5%. For thetreatment of data from document analysis and direct observation, the thematictechnique will be used to answer the research question. Qualitative data will beanalyzed using the content analysis technique, with the aim of objectively andsystematically identifying the manifest content, subjectively, in the participants'speeches on the guiding question addressed. The categorization technique will beused, according to the existing theme in the speeches, classifying it by keywords thatbest describe it. The project was submitted to the ethics committee of FOA-Unesp andaspects related to conducting research with human beings will be respected. (AU)