Social and geographical inequalities in the performance of prenatal care in a metropolitan area of Brazil.

Abstract:

:This study analyzed the social and geographical inequalities in the performance of prenatal medical care in the Unified Health System (SUS) in the Metropolitan Region of Grande Vitória, Espírito Santo, Brazil. A cross-sectional study was carried out with 1,209 puerperae living in this region, admitted for childbirth from 2010 to 2011. Data about prenatal care and contextual, enabling, and social characteristics were collected, following the Andersen's Behavioral Model. The performance of prenatal care was classified into five levels, including information on the number of prenatal visits, initial and repetitive examinations, tetanus vaccination, gestational risk management, and participation in educational activities. The likelihood of different levels of prenatal care performance was analyzed using a multivariate multinomial model, according to maternal social variables. High prenatal coverage (98%) and 4.4% care adequacy were identified. The likelihood of access to prenatal care was increased by enabling, contextual, and social factors. The relationship between prenatal care quality and pregnant women's social and geographical conditions must be considered in the organization of services to achieve equity and reduce maternal and perinatal morbimortality.

journal_name

Cien Saude Colet

journal_title

Ciencia & saude coletiva

authors

Esposti CDD,Santos-Neto ETD,Oliveira AE,Travassos C,Pinheiro RS

doi

10.1590/1413-81232020255.32852019

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

1735-1750

issue

5

eissn

1413-8123

issn

1678-4561

pii

S1413-81232020000501735

journal_volume

25

pub_type

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