Title:	Estudo de linha de base dos hospitais integrantes do projeto de melhoria da qualidade do ensino em obstetrícia e neonatologia
Authors:	Mendes, Yluska Myrna Meneses Brandão e
metadata.dc.contributor.email:	yluskamyrna@yahoo.com.br
Orientador(es)::	Rattner, Daphne
Assunto::	Maternidade Qualidade da assistência à saúde Hospitais de ensino Cesariana
Issue Date:	9-Feb-2024
Data de defesa::	16-Aug-2019
Citation:	MENDES, Yluska Myrna Meneses Brandão e. Estudo de linha de base dos hospitais integrantes do projeto de melhoria da qualidade do ensino em obstetrícia e neonatologia. 2019. 73 f., il. Dissertação (Mestrado Profissionalizante em Saúde Coletiva) — Universidade de Brasília, Brasília, 2019.
Abstract:	In Brazil, 98.5% of all births occur in hospitals, and there is a growing concern about the high cesarean section rates. The prevailing model of obstetric and neonatal care is the technocratic one, characterized by the use of a set of medical techniques, where women are submitted to recommended norms and routines, resulting in high rates of interventions and surgical births. Instituted in August 2017, the project ‘Aprimoramento e Inovação no Cuidado e Ensino em Obstetrícia e Neonatologia’ (Brazilian acronym Apice ON) aims to change the model of obstetric and neonatal care and involves teaching hospitals that are part of the Stork Network. Teaching hospitals define how future professionals learn, how they will incorporate attitudes and practices tuned into care models. Proposed in 2001, Robson’s classification of cesarean sections is a tool to monitor and evaluate cesarean section rates throughout a period of time in one same scenario and allows comparisons between different scenarios. Since 2011, the Information System on Live Births incorporated the necessary elements to apply Robson’s classification to births. This study aimed to describe teaching hospitals that participate in the Apice ON project broaching its structural and processual characteristics and analyzing the distribution of cesarean sections there performed according to Robson’s classification. Secondary data from National Registry of Healths Institutions (Cadastro Nacional de Estabelecimentos de Saúde - CNES), of the Hospitals Information System (Sistema de Informações Hospitalares – SIH) and of the Live Births Information System (Sistema de Informações sobre Nascidos Vivos -Sinasc), referring to year 2017, were used. The descriptive analysis of the variables of these hospitals characterizes the baseline study about the structure and process; besides, a descriptive study of their cesarean sections according to Robson’s classification was performed. Findings revealed that, before the project implementation, 66% of the hospitals were certified by the Baby Friendly Hospital Initiative, 3% offered care in their High Risk Pregnancy, Baby, and Post-Partum House and 45% adopted the Mother Kangaroo method; 97% had separated antenatal and delivery rooms; 9% did not offer rooming-in. The proportions of live births by Robson’s groups were similar to those proposed by the World Health Organization, besides for group 5 (with a previous cesarean section) and 10 (preterm), with regional variations. The average cesarean sections rates varied from 24.8% to 75.1%. Even in the groups considered of low risk for cesarean sections (1 to 4), the rates exceeded by large the ones recommended. The scenario for change seems to be promising, since there is a large distance between what is adopted and taught in these institutions and what should be. Monitoring and evaluation of cesarean sections using Robson’s classification may be important tools to guide management. This study shows the importance of including variables that will allow similar analyses in national information systems. Finally, this study strengthens the pertinence of the Apice ON project as inducer of change in the model of care in teaching hospitals, and thus, as a strategic one to make effective the national public policy represented by the Stork Network.
metadata.dc.description.unidade:	Faculdade de Ciências da Saúde (FS)
Description:	Dissertação (mestrado) — Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, 2019.
metadata.dc.description.ppg:	Programa de Pós-Graduação em Saúde Coletiva
Appears in Collections:	Teses, dissertações e produtos pós-doutorado

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