Assistência à gestante adolescente nas unidades de saúde do SUS no município do Rio de Janeiro

Abstract

Ensuring access to quality health services is necessary for good perinatal outcome. Pregnancy in adolescents may be associated with increased risk of obstetric complications such as preeclampsia, low birth weight, prematurity, and vertical transmission of HIV and syphilis. The increase in these complications is reflected in the increasing rates of maternal death. According to the parameters established by the Ministry of Health (2005), public health networks should ensure that antenatal consultations begin in the first quarter and occur at least six times during pregnancy. This study aims to map the SUS health services in the municipality of Rio de Janeiro that offer prenatal care for adolescents 10-19 years and assess their perception of their quality. Held in two phases, a quantitative and a qualitative, in the first phase was a survey of units and the types of services they offer. In the qualitative phase were developed in-depth interviews with adolescent wearers of these services. Of the 149 health facilities in the municipality, 148 units were visited, having been excluded by a unit does not take up the case. Of these, 6.8% (10) are hospitals, 56.7 % (84) correspond to Polyclinics and Centres Health and 36.5 % (54) are other FHP. The total units of existing municipal health at Rio de Janeiro , 95.3 % (141) perform pre -and postnatal care , 96.5 % (95% CI 91.5 to 98.8 %) to have medical care PN, only 47.5 % of the units have obstetricians (95% CI 39.1 to 56.1 %) and only 28.3 % (95% CI 17.5 to 41.4 %) have trained professionals in adolescent health. Regarding the presence of a nurse, it was found that 89.4 % (95% CI 83.1 to 93.9 %) of health facilities studied have such professional, but only 40.0 % (56) are trained in obstetrics. It was noted that some facilities still require the presence of responsible for making appointments or for completion of the pregnant adolescent care. With regard to medical care and nursing, both were considered good. A frequent complaint was related to diminished focus by some professional care with adolescents. An important record was preferred by patients by professional female, identified as more welcoming. In relation to nursing care, it seems that these professionals are not recognized as appropriate to assist PN and must prioritize the identification and recovery of its care. Educational, fundamental activities for the proper monitoring PN do not seem to be well implemented in healthcare facilities and also have failed in its disclosure, which reduces the adherence of adolescents to the activity. Although identified large supply of prenatal care in health facilities in the city of Rio de Janeiro, it was observed that adolescents, especially those under 15, have not shown adequate adherence to PN.