Access to health services and nursing care from a newborn care municipal program

Author(s)

Poliana Remundini de Lima

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC)
• Defense date: 2017-03-08

Examining board members

Maria Cândida de Carvalho Furtado; Débora Falleiros de Mello; Jair Licio Ferreira Santos; Monika Wernet

• Advisor: Maria Cândida de Carvalho Furtado

Abstract

Cross-sectional and analytical study that aimed to analyze the newborns (RN) access, after birth, to the nursing care in basic health network at an inner city of São Paulo state. We included RN, users of Brazilian Health System (SUS) that was born and lived in Preto Ribeirão from January 1st 2010 to December 31th 2014. Data were obtained from spreadsheets of the Floresce uma Vida Programme, belonging to Child Health Programme of Municipal Health Department (SMS). Variables studied were type of care unit, the newborn age, birth weight, maternal age, parity, and number of prenatal consultations, referral for specialized service, neonatal screening and BCG vaccine. Data were processing from the Floresce uma Vida database, using the Statistica software version 12.0. In descriptive analysis, we sought information that could identify improvement on access to health services, considering the child\'s care in the first week of life. In analytical analysis, we sought possible associations between the variables birth weight, maternal age and parity and the variable newborns access to nursing actions in the basic health network. For the spatial distribution of data related to access to nursing actions, we calculated the percentage of nursing actions that occurred according to the areas covered by the health services of Primary Care. The Research Ethics Committee approved the research (CAAE Nº 47836115.5.0000.5393, Oficio nº 152/2015). During the study period, 41,267 children were born; 54.4% are SUS users. We identified the occurrence of 19,234 (85.6%) nursing visits, 19,376 (86.3%) BCG vaccines and 19,769 (88.0%) neonatal screening. Through spatial analysis, we observed that Eastern and Central Health Districts showed the lowest percentage of achievement of nursing actions, even when we analyzed the performance of the three procedures on the same day. Recommended actions for the first week of life, such as newborn screening, BCG vaccine and nursing consultation, had lower coverage than expected, especially their performance on the same day. Among the children who did not have these three procedures on the same day, we identified, as most, those who had adequate weight at birth and whose mothers, aged 20 to 34, had seven or more prenatal consultations. The information obtained through the study, are a tool for managers and healthcare teams to identify the weaknesses that are amenable to intervention and re- evaluate the newborn care strategies, qualifying the assistance provided, through the guarantee of timely access and comprehensive care, transposing results for similar realities in the regional and / or national level (AU)

• FAPESP's process: 15/08154-2 - The access to health services and to nursing care from a Newborn´s Municipal Health Program
• Grantee: Poliana Remundini Lima
• Support Opportunities: Scholarships in Brazil - Master