Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha
Maternal health is an area of high interest for public health, the main indicator of which is the maternal mortality rate. High rates of this indicator are characteristic of underdeveloped countries such as Brazil, which can be avoided, most of the time, through actions such as quality prenatal ca...
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Saúde materna Mortalidade materna Indicadores básicos de saúde Serviços de saúde Saúde pública Política pública |
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Saúde materna Mortalidade materna Indicadores básicos de saúde Serviços de saúde Saúde pública Política pública Souza, Dandara Rayssa Silva de Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha |
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Maternal health is an area of high interest for public health, the main indicator of which is the
maternal mortality rate. High rates of this indicator are characteristic of underdeveloped countries
such as Brazil, which can be avoided, most of the time, through actions such as quality prenatal care
and adequate assistance in childbirth and postpartum. In this perspective, several policies were
instituted to promote improvements in maternal health, among which the most current is the Stork
Network, instituted in 2011. Thus, the general objective of this work is to assess maternal health
before and after the implementation of the Stork Network in Brazil. To achieve this objective, it was
proposed to conduct a quantitative study of the mixed ecological type, with an analytical character,
on maternal health before and after the implementation of the Stork Network in Brazil, using the
municipalities, intermediate regions of urban articulation as the unit of analysis, federation units and
regions. In addition, the maternal mortality coefficient, adherence to the Stork Network, nine
socioeconomic and demographic indicators, three indicators of maternal health quality and the
coverage of primary care were considered as variables. All data that composed the variables were
obtained from secondary sources of public access. For data treatment and analysis, Microsoft Office
Excel, Statistical Package for the Social Science (SPSS) and Geoda software were used, in which
graphs, tables, maps and statistical tests were made for analysis under the perspective of descriptive
and inferential statistics, including spatial analysis. The results show that there was an increase in
the average of the maternal mortality coefficient from 5.99 to 6.28 per 10,000 live births, from the
period prior to the period after the implementation of the Stork Network, among which the highest
coefficients were those in the Northern regions and Northeast, which also had the worst
socioeconomic and demographic indicators. Among the municipalities in Brazil, 61.15% joined the
Stork Network until the last year studied, with the highest percentages recorded in the North region.
The correlation of maternal mortality with the Human Development Index variables, households
with running water, life expectancy at birth, aging rate and schooling worsened from the first to the
second period. The distribution of mean maternal mortality in relation to adherence to the Stork
Network shows that in recent years the average of maternal mortality has been lower in the
municipalities that adhered to the Stork Network than in those that did not adhere. The spatial
correlation of adherence to the Stork Network with maternal mortality reveals significant high-high
and low-high clusters located in the North, Northeast and Midwest regions, and low-low and highlow clusters located in the Southeast regions and South. Maternal health indicators reveal that after
joining the Stork Network there was a constant increase in the breastfeeding coefficient, the number
of prenatal consultations and the percentage of pregnant women who started prenatal care in the
first trimester of pregnancy. The dispersion of the percentage of adhesion to the Stork Network with
the percentage of coverage of primary care reveals that both increased concomitantly in the second
period analyzed. It can be concluded that it is important to encourage the implementation of the
Stork Network, which has been taking place gradually in the municipalities of Brazil from 2012 to
2017 (reaching 61% in the last year), aiming at uniformity in the processes of maternal and child
health care. The increase in maternal mortality after the implementation of the Stork Network can
be attributed to greater exposure to risk factors and changes in the lifestyle of women today, as well
as to the improvement in the notification process of maternal deaths in recent years. In addition, in
the long term there was a potential effect of lower maternal mortality in the municipalities that
joined the Stork Network. |
| author2 |
Andrade, Fabia Barbosa de |
| author_facet |
Andrade, Fabia Barbosa de Souza, Dandara Rayssa Silva de |
| format |
masterThesis |
| author |
Souza, Dandara Rayssa Silva de |
| author_sort |
Souza, Dandara Rayssa Silva de |
| title |
Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha |
| title_short |
Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha |
| title_full |
Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha |
| title_fullStr |
Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha |
| title_full_unstemmed |
Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha |
| title_sort |
saúde materna no brasil: estudo ecológico de avaliação da implantação da rede cegonha |
| publisher |
Universidade Federal do Rio Grande do Norte |
| publishDate |
2021 |
| url |
https://repositorio.ufrn.br/handle/123456789/31762 |
| work_keys_str_mv |
AT souzadandararayssasilvade saudematernanobrasilestudoecologicodeavaliacaodaimplantacaodaredecegonha |
| _version_ |
1797696426150461440 |
| spelling |
ri-123456789-317622024-03-19T04:02:14Z Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha Souza, Dandara Rayssa Silva de Andrade, Fabia Barbosa de http://lattes.cnpq.br/7146673263226557 http://lattes.cnpq.br/0315846984480655 Costa, Cintia Bezerra Almeida http://lattes.cnpq.br/6281513299605740 Machado, Flávia Christiane de Azevedo http://lattes.cnpq.br/0790763211909338 Saúde materna Mortalidade materna Indicadores básicos de saúde Serviços de saúde Saúde pública Política pública Maternal health is an area of high interest for public health, the main indicator of which is the maternal mortality rate. High rates of this indicator are characteristic of underdeveloped countries such as Brazil, which can be avoided, most of the time, through actions such as quality prenatal care and adequate assistance in childbirth and postpartum. In this perspective, several policies were instituted to promote improvements in maternal health, among which the most current is the Stork Network, instituted in 2011. Thus, the general objective of this work is to assess maternal health before and after the implementation of the Stork Network in Brazil. To achieve this objective, it was proposed to conduct a quantitative study of the mixed ecological type, with an analytical character, on maternal health before and after the implementation of the Stork Network in Brazil, using the municipalities, intermediate regions of urban articulation as the unit of analysis, federation units and regions. In addition, the maternal mortality coefficient, adherence to the Stork Network, nine socioeconomic and demographic indicators, three indicators of maternal health quality and the coverage of primary care were considered as variables. All data that composed the variables were obtained from secondary sources of public access. For data treatment and analysis, Microsoft Office Excel, Statistical Package for the Social Science (SPSS) and Geoda software were used, in which graphs, tables, maps and statistical tests were made for analysis under the perspective of descriptive and inferential statistics, including spatial analysis. The results show that there was an increase in the average of the maternal mortality coefficient from 5.99 to 6.28 per 10,000 live births, from the period prior to the period after the implementation of the Stork Network, among which the highest coefficients were those in the Northern regions and Northeast, which also had the worst socioeconomic and demographic indicators. Among the municipalities in Brazil, 61.15% joined the Stork Network until the last year studied, with the highest percentages recorded in the North region. The correlation of maternal mortality with the Human Development Index variables, households with running water, life expectancy at birth, aging rate and schooling worsened from the first to the second period. The distribution of mean maternal mortality in relation to adherence to the Stork Network shows that in recent years the average of maternal mortality has been lower in the municipalities that adhered to the Stork Network than in those that did not adhere. The spatial correlation of adherence to the Stork Network with maternal mortality reveals significant high-high and low-high clusters located in the North, Northeast and Midwest regions, and low-low and highlow clusters located in the Southeast regions and South. Maternal health indicators reveal that after joining the Stork Network there was a constant increase in the breastfeeding coefficient, the number of prenatal consultations and the percentage of pregnant women who started prenatal care in the first trimester of pregnancy. The dispersion of the percentage of adhesion to the Stork Network with the percentage of coverage of primary care reveals that both increased concomitantly in the second period analyzed. It can be concluded that it is important to encourage the implementation of the Stork Network, which has been taking place gradually in the municipalities of Brazil from 2012 to 2017 (reaching 61% in the last year), aiming at uniformity in the processes of maternal and child health care. The increase in maternal mortality after the implementation of the Stork Network can be attributed to greater exposure to risk factors and changes in the lifestyle of women today, as well as to the improvement in the notification process of maternal deaths in recent years. In addition, in the long term there was a potential effect of lower maternal mortality in the municipalities that joined the Stork Network. A saúde materna é uma área de elevado interesse para a saúde pública, cujo principal indicador é o coeficiente de mortalidade materna. Altos índices desse indicador são característicos de países em desenvolvimento como o Brasil, o que pode ser evitado, na maioria das vezes, através de ações como o pré-natal de qualidade e a assistência adequada no parto e pós-parto. Nessa perspectiva foram instituídas diversas políticas para promover melhorias na saúde materna, entre as quais a mais atual é a Rede Cegonha, instituída em 2011. Assim, o objetivo geral deste trabalho é avaliar a saúde materna antes e após a implementação da Rede Cegonha no Brasil. Para alcançar esse objetivo, propôs-se realizar um estudo quantitativo do tipo ecológico misto, com caráter analítico, sobre a saúde materna antes e após a implementação da Rede Cegonha no Brasil, tendo como unidade de análise os municípios, as regiões intermediárias de articulação urbana, as unidades da federação e as regiões. Além disso, considerou-se como variáveis o coeficiente de mortalidade materna, a adesão à Rede Cegonha, nove indicadores socioeconômicos e demográficos, três indicadores da qualidade da saúde materna e a cobertura da atenção básica. Todos os dados que compuseram as variáveis foram obtidos de fontes secundárias de acesso público. Para tratamento e análise dos dados foram utilizados os softwares Microsoft Office Excel, Statistical Package for the Social Science (SPSS) e Geoda, nos quais foram feitos gráficos, tabelas, mapas e testes estatísticos para a análise sob olhar da estatística descritiva e da estatística inferencial, incluindo a análise espacial. Os resultados demonstram que houve aumento na média do coeficiente de mortalidade materna de 5,99 para 6,28 por 10 mil nascidos vivos, do período anterior ao período posterior à implementação da Rede Cegonha, entre os quais os maiores coeficientes foram os das regiões Norte e Nordeste, que também obtiveram os piores indicadores socioeconômicos e demográficos. Entre os municípios do Brasil, 61,15% aderiram à Rede Cegonha até o ano de 2017, com maiores percentuais registrados na região Norte. A correlação da mortalidade materna com as variáveis Índice de Desenvolvimento Humano, domicílios com água encanada, esperança de vida ao nascer, taxa de envelhecimento e escolaridade piorou do primeiro para o segundo período estudados. A distribuição de médias da mortalidade materna em relação à adesão à Rede Cegonha demonstra que nos últimos anos a média da mortalidade materna foi menor nos municípios que aderiram à Rede Cegonha do que naqueles que não aderiram. A correlação espacial da adesão à Rede Cegonha com a mortalidade materna revela clusters significativos de alto-alto e de baixo-alto localizados nas regiões Norte, Nordeste e Centro-Oeste, e clusters de baixo-baixo e de alto-baixo localizados nas regiões Sudeste e Sul. Os indicadores da saúde materna revelam que após a adesão à Rede Cegonha houve aumento constante do coeficiente de aleitamento materno, do número de consultas de prénatal e do percentual de gestantes que iniciaram o pré-natal no primeiro trimestre da gestação. A dispersão do percentual de adesão à Rede Cegonha com o percentual de cobertura da atenção básica revela que ambos aumentaram concomitantemente no segundo período analisado. Pode-se concluir que é importante incentivar a implementação da Rede Cegonha, que vem ocorrendo gradativamente nos municípios do Brasil desde 2012 (alcançando 61% no ano de 2017), visando a uniformidade nos processos de cuidado à saúde materna e infantil. O aumento da mortalidade materna após a implementação da Rede Cegonha pode ser atribuído à maior exposição aos fatores de risco e mudanças no estilo de vida das mulheres na atualidade, bem como à melhoria no processo de notificação das mortes maternas nos últimos anos. Além disso, a longo prazo notou-se potencial efeito de menor mortalidade materna nos municípios que aderiram à Rede Cegonha. 2021-08-04 2021-03-09T00:09:34Z 2020-06-19 masterThesis SOUZA, Dandara Rayssa Silva de. Saúde materna no Brasil: estudo ecológico de avaliação da implantação da rede cegonha. 2020. 85f. Dissertação (Mestrado em Saúde Coletiva) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2020. https://repositorio.ufrn.br/handle/123456789/31762 pt_BR Acesso Embargado application/pdf Universidade Federal do Rio Grande do Norte Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA |