Pedro Miguel dos Santos Neto

Childbirth care in Brazil: a critical situation has not yet been overcome. 1999-2013

Objectives: to analyze the evolution of childbirth care in Brazil, between 1999-2013. Methods: a time-series ecological study, using data from Ministry of Health, Brazilian Institute of Geography and Statistics, and Interagency Network of Information for Health. 18 indicators were analyzed related to childbirth and mortality. Results: there was a reduction in rates of fertility, natality and the total number of births, with increased cesarean surgeries. Growth of prenatal consultation, intensive care beds and reduction of beds in obstetrics sector. The significant growth of caesarean deliveries, prenatal consultation coverage and concentration of births in hospitals occurred simultaneously with the growth: of preventable child deaths by adequate attention, management causes and appropriate delivery, prematurity; low weight; Downs syndrome; and the persistence of maternal deaths due to direct obstetric causes. Conclusions: persists hegemonic technocratic model of childbirth care without considering the observed changes in the profile of mothers and births, with slow reduction of perinatal and neonatal deaths and maintenance of high maternal mortality demonstrating that the critical situation of delivery care model in Brazil has not, yet, been overcome.

Modelos de gestão pública da Secretaria de Saúde de Pernambuco: implicações na gestão do trabalho

RESUMO Trata-se de um estudo de caso unico com enfoque incorporado de base qualitativa, exploratorio e retrospectivo, cujo objetivo foi analisar como a gestao do trabalho em saude e praticada em diferentes modelos de gestao publica no estado de Pernambuco, estudando dois hospitais: um gerenciado por Organizacao Social de Saude e o outro sob gestao direta. Foram realizadas entrevistas semiestruturadas, alem de analise documental no periodo de 2007 a 2013. O estudo apontou que o modelo de gestao publica se deu a partir da necessidade de expansao da rede de saude; alem de que existe uma Politica de Gestao do Trabalho implantada na Secretaria Estadual de Saude, com disparidade nos hospitais estudados.