Abstract
The article describes the temporal evolution of prenatal quality indicators in the primary health care network in Brazil and investigates regional differences. This study used data from the external evaluation of Brazil's National Program for Improving Primary Care Access and Quality (PMAQ) with health teams participating in Cycles I, II and III of the Program, carried out respectively in 2012, 2013/14 and 2017/18. The number of visits, physical examination procedures, guidelines and request for laboratory tests were investigated. There was a positive evolution for tests-HIV, syphilis, blood glucose and ultrasound, and for all tests, guidance on feeding and weight gain of the baby and examination of the oral cavity. The indicators that performed the worst were: performance of tetanus vaccine, six or more visits, receiving guidance on exclusive breastfeeding and care for the newborn, and the procedures-all, measurement of uterine height, gynecological exam and cervix cancer prevention. These changes had a varied behavior between the regions of the country.
MeSH terms
-
Brazil
-
Cross-Sectional Studies
-
Family Health
-
Female
-
Health Services Accessibility*
-
Humans
-
Infant
-
Infant, Newborn
-
Pregnancy
-
Prenatal Care / standards*
-
Primary Health Care / standards*
-
Quality of Health Care / standards*
-
Socioeconomic Factors*
Grants and funding
The data from this study were produced within the scope of an external evaluation process of the Program for Improving Access and Quality of Primary Care (PMAQ-AB). This program was fully funded by the Ministry of Health, which transferred resources to several federal universities for them to conduct fieldwork in 2012, 2013/2014 and 2017/2018. Resources were decentralized to Universities and managed by supporting foundations. In our case, the Federal University of Pelotas and the Delfim Mendes da Silveira Foundation (FDMS) and the University Support Foundation (FAU). The resources were mainly applied in tickets and daily rates for interviewers, acquisition of tablets and accessories, and research grants. Research grants were not a salary, they were a temporary incentive for researchers to dedicate themselves to the project's activities. Data are available in open access to the entire population. Our research group – and others across the country – has been producing several scientific articles, published in Brazil and abroad, since 2013. In total, the amount transferred to our institution, responsible for 20% of data collection throughout Brazil, was $3,386,415.The Ministry of Health only guided the development and standardization of data collection instruments, so that the information collected by the universities could also be used in the teams' certification process. This certification defined the values of transfers to municipalities. Funders did not participate in data analysis, decision to publish or preparation of the manuscript.