Mariza Silva Almeida

Integralidade do cuidado à saúde da mulher: limites da prática profissional

Abstract Resumen The current policy of full attention to women’s health proposesthe incorporation of the principle of integrality and the size ofgender in professional practices. This qualitative study wastherefore aimed at encouraging reflection and discussion amonga multiprofessional team about women’s health care practicesand identifying those aspects that might weaken or strengthenthe integrality perspective. It was carried out in a primary healthunit in Salvador (Bahia, Brazil), in 2005 and 2006, having assubjects women’s health care practitioners from differenteducational backgrounds who took part in three reflectionworkshops. Data were analyzed by means of discourse analysistechniques assuming gender and integrality as the theoreticalframework. The multiprofessional team was shown to recognizethe fact that their female clientele face situations of class andgender inequalities as well as unequal and authoritarianrelationships at the health unit. Integrality was absent from theprofessional practices under study, a fact also recognized by thehealth care team who, although being able to identify theweaknesses, is unable to mobilize its potential for collectiveorganization in order to effect change.Keywords: Women’s health. P rimary health care. Public PoliciesResumen The current policy of full attention to women’s health proposes the incorporation of the principle of integrality and the size of gender in professional practices. This qualitative study was therefore aimed at encouraging reflection and discussion among a multiprofessional team about women’s health care practices and identifying those aspects that might weaken or strengthen the integrality perspective. It was carried out in a primary health unit in Salvador (Bahia, Brazil), in 2005 and 2006, having as subjects women’s health care practitioners from different educational backgrounds who took part in three reflection workshops. Data were analyzed by means of discourse analysis techniques assuming gender and integrality as the theoretical framework. The multiprofessional team was shown to recognize the fact that their female clientele face situations of class and gender inequalities as well as unequal and authoritarian relationships at the health unit. Integrality was absent from the professional practices under study, a fact also recognized by the health care team who, although being able to identify the weaknesses, is unable to mobilize its potential for collective organization in order to effect change.

O cuidado da criança prematura no domicílio

ABSTRACT Objectives: To characterize and describe home care to the premature baby provided by mothers or other caretakers. Methods: Adescriptive qualitative study was used. Seven caretakers were interviewed in their homes. The data were collected through semi-structuredinterview and analyzed using content analysis. Results: The emerged categories were: caring for the premature baby at home; living andinteracting with the premature baby; and, the importance of social support in caring for the premature baby. Conclusions: The mothers, ascaretakers, provided proper care to the premature baby, expressed concerns regarding the baby™s development and growth, and voiced theneed of support to deliver proper care. Keywords: Infant premature; Infant care; Caregivers; Mother-child relations RESUMO Objetivos: Identificar o cuidado domiciliar prestado pela mae e/ou responsAEveis pelo cuidado da crianca prematura; descrever o cuidadoprestado ao prematuro no domicilio e os aspectos que interferem neste processo.Objectives: To characterize and describe home care to the premature baby provided by mothers or other caretakers. Methods: A descriptive qualitative study was used. Seven caretakers were interviewed in their homes. The data were collected through semi-structured interview and analyzed using content analysis. Results: The emerged categories were: caring for the premature baby at home; living and interacting with the premature baby; and, the importance of social support in caring for the premature baby. Conclusions: The mothers, as caretakers, provided proper care to the premature baby, expressed concerns regarding the baby’s development and growth, and voiced the need of support to deliver proper care.ABSTRACT Objectives: To characterize and describe home care to the premature baby provided by mothers or other caretakers. Methods: Adescriptive qualitative study was used. Seven caretakers were interviewed in their homes. The data were collected through semi-structuredinterview and analyzed using content analysis. Results: The emerged categories were: caring for the premature baby at home; living andinteracting with the premature baby; and, the importance of social support in caring for the premature baby. Conclusions: The mothers, ascaretakers, provided proper care to the premature baby, expressed concerns regarding the baby™s development and growth, and voiced theneed of support to deliver proper care. Keywords: Infant premature; Infant care; Caregivers; Mother-child relations RESUMO Objetivos: Identificar o cuidado domiciliar prestado pela mae e/ou responsAEveis pelo cuidado da crianca prematura; descrever o cuidadoprestado ao prematuro no domicilio e os aspectos que interferem neste processo.

Necessidades de mulheres no puerpério imediato em uma maternidade pública de Salvador, Bahia, Brasil

Objetivando identificar as necessidades de puerperas que demandam cuidados de enfermagem e compreender como elas percebem os cuidados de enfermagem durante sua permanencia no Alojamento Conjunto, realizamos uma pesquisa descritiva com dados qualitativos, orientados pela perspectiva de genero. Entrevistamos 25 mulheres que se encontravam internadas em unidade de Alojamento Conjunto de uma maternidade publica de Salvador-Bahia. A analise de conteudo na modalidade tematica conduziu-nos a apreensao de duas categorias: a necessidade de acolhimento e necessidade de cuidados fisicos. O resultado deste estudo aponta para a necessidade de modificacoes na pratica e no modo de cuidar da enfermagem, nao somente nos procedimentos tecnicos, mas tambem na incorporacao de valores e iniciativas humanizadoras do cuidado.In order to identify womens needs in their immediate puerperium and to understand their perception of the nursing care they received during this period, the authors developed a descriptive study with qualitative data in a gender perspective. Twenty-five women were interviewed in a public hospital in Salvador, State of Bahia. From the contents analysis, in which a thematic approach was used, emerged two categories: the need for physical care and for a gentle welcome. The study results point out to the need for a change in nursing practices, which should incorporate values and humanitarian initiatives as well as technical procedures.

Home care of the premature baby

ABSTRACT Objectives: To characterize and describe home care to the premature baby provided by mothers or other caretakers. Methods: Adescriptive qualitative study was used. Seven caretakers were interviewed in their homes. The data were collected through semi-structuredinterview and analyzed using content analysis. Results: The emerged categories were: caring for the premature baby at home; living andinteracting with the premature baby; and, the importance of social support in caring for the premature baby. Conclusions: The mothers, ascaretakers, provided proper care to the premature baby, expressed concerns regarding the baby™s development and growth, and voiced theneed of support to deliver proper care. Keywords: Infant premature; Infant care; Caregivers; Mother-child relations RESUMO Objetivos: Identificar o cuidado domiciliar prestado pela mae e/ou responsAEveis pelo cuidado da crianca prematura; descrever o cuidadoprestado ao prematuro no domicilio e os aspectos que interferem neste processo.Objectives: To characterize and describe home care to the premature baby provided by mothers or other caretakers. Methods: A descriptive qualitative study was used. Seven caretakers were interviewed in their homes. The data were collected through semi-structured interview and analyzed using content analysis. Results: The emerged categories were: caring for the premature baby at home; living and interacting with the premature baby; and, the importance of social support in caring for the premature baby. Conclusions: The mothers, as caretakers, provided proper care to the premature baby, expressed concerns regarding the baby’s development and growth, and voiced the need of support to deliver proper care.ABSTRACT Objectives: To characterize and describe home care to the premature baby provided by mothers or other caretakers. Methods: Adescriptive qualitative study was used. Seven caretakers were interviewed in their homes. The data were collected through semi-structuredinterview and analyzed using content analysis. Results: The emerged categories were: caring for the premature baby at home; living andinteracting with the premature baby; and, the importance of social support in caring for the premature baby. Conclusions: The mothers, ascaretakers, provided proper care to the premature baby, expressed concerns regarding the baby™s development and growth, and voiced theneed of support to deliver proper care. Keywords: Infant premature; Infant care; Caregivers; Mother-child relations RESUMO Objetivos: Identificar o cuidado domiciliar prestado pela mae e/ou responsAEveis pelo cuidado da crianca prematura; descrever o cuidadoprestado ao prematuro no domicilio e os aspectos que interferem neste processo.

Associação entre gravidez não planejada e o contexto socioeconômico de mulheres em área da Estratégia Saúde da Família

OBJECTIVE: To estimate the prevalence of unplanned pregnancy and verify its association with sociodemographic factors in women enrolled in the FHS - Family Health Strategy, in suburban sanitary Salvador - BA. METHODS: A quantitative, exploratory, cross-sectional study, with a sample of 191 pregnant women, stratified by health units. The pregnancy was categorized into planned and unplanned, and sociodemographic characteristics constituted the independent variables. The magnitude of the associations was obtained by the ratio of prevalence and confidence intervals (95%), estimated by Poisson regression, with the level of statistical significance, 5% (p < 0.05). RESULTS: The prevalence of unplanned pregnancy was 66.5%; age, marital status, occupational situation, and income exhibited statistically significant proportional differences with regard to type of pregnancy. There was a positive association between age, marital status and occupation with unplanned pregnancy. CONCLUSIONS: The results reaffirm the association between unplanned pregnancy and socioeconomic conditions, and the ESF appears to have been effective in ensuring the reproductive rights of women.

Indicadores de qualidade da assistência pré-natal em Salvador - Bahia

OBJETIVO: Analisar indicadores de qualidade da assistencia pre-natal prestada por servicos publicos de saude de Salvador/Ba, apos a implantacao do Programa de Humanizacao no Pre-natal e Nascimento (PHPN). METODOS: Estudo quantitativo realizado nas unidades basicas de saude de Salvador que aderiram ao Programa de Humanizacao no Pre-natal e Nascimento . RESULTADOS: Baixo percentual de gestantes inscritas no Programa de Humanizacao no Pre-natal e Nascimento realizaram seis consultas de pre-natal (9,76%); mais da metade dessas mulheres realizaram todos exames basicos e houve baixo percentual das que compareceram a consulta de puerperio (5,66%). Ademais, apenas 5,66% concluiram a assistencia pre-natal. CONCLUSAO: assistencia pre-natal em Salvador, prestada atraves do Programa de Humanizacao no Pre-natal e Nascimento no ano 2002, caracteriza-se por baixa cobertura pelas unidades de saude tanto de consultas pre-natais quanto de exames basicos e consulta puerperal.OBJECTIVE: To analyze prenatal care quality indexes of public health services in Salvador, Bahia following the implementation of the Prenatal and Birth Humanization Program (PBHB). METHODS: This quantitative descriptive study was conducted in primary care units in Salvador that adopted the Prenatal and Birth Humanization Program. RESULTS: Few pregnant women registered in the Prenatal and Birth Humanization Program had the benchmark of six prenatal consultations (9.76%). More than half of these registered pregnant women received all basic exams. However, only few women received puerperal consultations (5.66%), which conclude their maternal care. CONCLUSION: Prenatal care in Salvador, carried out through the Prenatal and Birth Humanization Program in 2002, had a low performance in basic exams, and in prenatal and puerperal consultations.

Women's needs in immediate puerperium in a public maternity in Salvador, Bahia, Brazil

Objetivando identificar as necessidades de puerperas que demandam cuidados de enfermagem e compreender como elas percebem os cuidados de enfermagem durante sua permanencia no Alojamento Conjunto, realizamos uma pesquisa descritiva com dados qualitativos, orientados pela perspectiva de genero. Entrevistamos 25 mulheres que se encontravam internadas em unidade de Alojamento Conjunto de uma maternidade publica de Salvador-Bahia. A analise de conteudo na modalidade tematica conduziu-nos a apreensao de duas categorias: a necessidade de acolhimento e necessidade de cuidados fisicos. O resultado deste estudo aponta para a necessidade de modificacoes na pratica e no modo de cuidar da enfermagem, nao somente nos procedimentos tecnicos, mas tambem na incorporacao de valores e iniciativas humanizadoras do cuidado.In order to identify womens needs in their immediate puerperium and to understand their perception of the nursing care they received during this period, the authors developed a descriptive study with qualitative data in a gender perspective. Twenty-five women were interviewed in a public hospital in Salvador, State of Bahia. From the contents analysis, in which a thematic approach was used, emerged two categories: the need for physical care and for a gentle welcome. The study results point out to the need for a change in nursing practices, which should incorporate values and humanitarian initiatives as well as technical procedures.

Prenatal care quality indexes of public health services in Salvador, Bahia

OBJETIVO: Analisar indicadores de qualidade da assistencia pre-natal prestada por servicos publicos de saude de Salvador/Ba, apos a implantacao do Programa de Humanizacao no Pre-natal e Nascimento (PHPN). METODOS: Estudo quantitativo realizado nas unidades basicas de saude de Salvador que aderiram ao Programa de Humanizacao no Pre-natal e Nascimento . RESULTADOS: Baixo percentual de gestantes inscritas no Programa de Humanizacao no Pre-natal e Nascimento realizaram seis consultas de pre-natal (9,76%); mais da metade dessas mulheres realizaram todos exames basicos e houve baixo percentual das que compareceram a consulta de puerperio (5,66%). Ademais, apenas 5,66% concluiram a assistencia pre-natal. CONCLUSAO: assistencia pre-natal em Salvador, prestada atraves do Programa de Humanizacao no Pre-natal e Nascimento no ano 2002, caracteriza-se por baixa cobertura pelas unidades de saude tanto de consultas pre-natais quanto de exames basicos e consulta puerperal.OBJECTIVE: To analyze prenatal care quality indexes of public health services in Salvador, Bahia following the implementation of the Prenatal and Birth Humanization Program (PBHB). METHODS: This quantitative descriptive study was conducted in primary care units in Salvador that adopted the Prenatal and Birth Humanization Program. RESULTS: Few pregnant women registered in the Prenatal and Birth Humanization Program had the benchmark of six prenatal consultations (9.76%). More than half of these registered pregnant women received all basic exams. However, only few women received puerperal consultations (5.66%), which conclude their maternal care. CONCLUSION: Prenatal care in Salvador, carried out through the Prenatal and Birth Humanization Program in 2002, had a low performance in basic exams, and in prenatal and puerperal consultations.

Association between unplanned pregnancy and the socioeconomic context of women in the area of family health

OBJECTIVE: To estimate the prevalence of unplanned pregnancy and verify its association with sociodemographic factors in women enrolled in the FHS - Family Health Strategy, in suburban sanitary Salvador - BA. METHODS: A quantitative, exploratory, cross-sectional study, with a sample of 191 pregnant women, stratified by health units. The pregnancy was categorized into planned and unplanned, and sociodemographic characteristics constituted the independent variables. The magnitude of the associations was obtained by the ratio of prevalence and confidence intervals (95%), estimated by Poisson regression, with the level of statistical significance, 5% (p < 0.05). RESULTS: The prevalence of unplanned pregnancy was 66.5%; age, marital status, occupational situation, and income exhibited statistically significant proportional differences with regard to type of pregnancy. There was a positive association between age, marital status and occupation with unplanned pregnancy. CONCLUSIONS: The results reaffirm the association between unplanned pregnancy and socioeconomic conditions, and the ESF appears to have been effective in ensuring the reproductive rights of women.

Factors Associated with Abortion in Women of Reproductive Age

Purpose To verify sociodemographic factors associated with the occurrence of abortion in women of reproductive age, in areas covered by the Family Health Strategy (FHS), a program from the Brazilian Ministry of Health. Methods A cross-sectional study using household surveys of 350 women aged 15 to 49. The report of abortion was a variable indicator, and sociodemographic aspects were covariables. Prevalence ratio (PR) and respective 95% confidence intervals were used to estimate the magnitude of the associations. Results There were associations among age, civil status, race/color, and religion; an increase in the prevalence of lower levels of education, age less than 20, and student status were protective factors. Conclusion The association between sociodemographic characteristics and the report of abortion is attributed to the fact that there is a lack at the FHS in the availability of fundamental healthcare services for young women; these findings call for action to guarantee the access to information about contraceptives and guidance to decrease the risk of unplanned pregnancies and abortions.