Saúde reprodutiva em Uberlândia MG: uma avaliação dos serviços pelos usuários e prestadores

Abstract

This work is the result of an agreement between the Universidade Federal de Uberlândia and the Universidade do Minho (Portugal) in 2013, which scope included the analysis of care programs offered to the population of Uberlândia (MG) related to reproductive health, considering its effectiveness and effecacy in the perception of users and employees in relation to the services, which are considered as objects and central objectives of this dissertation. To this aim, it conducted a situational diagnosis of maternal and child care using the ratio of maternal mortality, near miss and an assessment of the perceptions of professionals and users of the Sistema Único de Saúde. The analyzes showed that existing reproductive health policies evolved from the exclusively curative service and had the aim only to ensure the reproductive capacity of women, as in the biomedical view, to the inclusion of comprehensive health care programs to various segments of society. Currently, most of the reproductive health care occurs through the primary health care, particularly by the Family Health Strategy. Although current policies seek to comply with the gender issue and humanization, its effectiveness usually focuses on healing issues at the expense of health promotion, by the lack of training of staff and structure or the daily work. This procedure perpetuates the biomedical vision of care and makes it necessary to systematically carry out assessments. The assessment of knowledge and perceptions of users and health professionals about reproductive health indicated that it is necessary to: (a) provide training courses for professionals; (b) carry out comprehensive guidance to users, particularly on contraception and family planning; (c) disclose the available services. One of the common problems is the existence of a vicious circle in which the health users do not know the services so do not seek them; if not seek them, they are not informed. With the abstention of health professionals in carrying out guidance on various aspects of reproductive health, this role has been assumed by family, friends, school, religious leaders and media, improving users knowledge, however in a partial way and that hinders their effective citizenship. A situational analysis of the maternalnewborn health care in Uberlândia indicated that maternal mortality is a result from a negligent prenatal care and there is a predominance in due to obstetric complications. This is worrying since the occurrence of cesareans tends to increase and shows the necessity of a improvement of prenatal and of early identification of pregnant women. The analysis of the perceptions showed the quality of the service and indicated that there were cases of lack of humanization of childbirth. Finally, it was evidenced that most problems in reproductive health care attencion in this research may be resolved with the effectuation of the Stork Network Program, which aims the expansion and improvement of prenatal care, training of professionals and humanized care. It also reinforces the need to practice health promotion, which is a new paradigm that should be better worked at the healthcare centers.