Avaliação da qualidade de assistência pré-natal no fortalecimento dos atributos da atenção primária à saúde

Abstract

Objective: To evaluate the quality of prenatal care services offered by primary health care, according to their essential and derived attributes. Method: Cross-sectional observational study with a quantitative approach. It comprised 96 health professionals who provide prenatal care in primary health care. Two questionnaires were administered: one for socio-demographic characterization and the other based on the Primary Care Assessment Tool (PCATool-Brazil) - version for doctors and nurses. The Statistical Package for Social Science (SPSS), version 20.0, was used to analyze the data, applying descriptive and inferential statistics using the t-test and considering a significance level of 5% (p≤0.05). The attributes of Primary Health Care were calculated according to the instrument. The variables of interest were the "number of health units" and "administrative regions of the municipality". Results: There was a predominance of women aged between 20 and 35 (43.5%), with a partner (68.1%), without children (66.7%), with more than six years' training or more (81.2%), and with Lato Sensu postgraduate degrees (84.1%). The area of postgraduate study was public health (48.3%) and only 17.2% of the participants reported having specialized in Women's Health. Concerning work variables, most of the sample was made up of nurses (71.0%), with employment contracts (76.8%) and predominantly working in the family health strategy (92.8%). It can be seen that in the attributes Comprehensiveness - Services Available (p=<0.001), Comprehensiveness - Services Provided (p=0.03), Family Orientation (p=0.02) and Community Orientation (p=<0.01), professionals who worked in a single service had a higher score than professionals who worked in two or more, which also happened in the overall score (p=0.01). When the attributes were compared with the regions in which they worked, their significance was observed in the CÉU (comprehensiveness - services provided (p=0.04)), HB (essential primary health care score (p=0.03)), Pinheirinho (longitudinality (p=0.02) and overall score (p=0.04)), Represa (accessibility (p=0.05)), Vila Toninho (comprehensiveness - services provided (p=0.03), family orientation (p≤0.01) and overall score (p=0.01)) regions. Conclusion: This study showed that working in more than one primary care service is detrimental to the quality of prenatal care in the municipality studied. Strengthening prenatal care requires strategies to link professionals to the unit where they work and opens reflection on the prenatal care provided by specialists and how this has had a negative impact on essential and derived attributes, which are key points for strengthening ties with the population. The social impact of the study reveals the quality of prenatal care services provided by the SUS, offering subsidies for managers to reformulate obstetric care policies.