| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 3.49 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Enfrentar a mortalidade materna e neonatal no mundo e nos países desfavorecidos, em especial, é um imperativo que se acentua com a evidência de que as causas do problema são conhecidas e relativamente simples de enfrentar, nomeadamente no âmbito das funções dos profissionais de enfermagem. A Mortalidade Materna e a Neonatal por um lado e, o estado de desenvolvimento dos países e das comunidades, por outro, são indicadores fundamentais na análise e conhecimento dos níveis de saúde dos povos, pois a sua estreita inter-relação, alimenta e favorece situações de pobreza que, por sua vez, se constituem como obstáculo ao próprio desenvolvimento. As Nações Unidas e outras agências internacionais com responsabilidade na abordagem desta situação, desenvolveram, através da agenda dos Objetivos de Desenvolvimento do Milénio, -ano 2000-, e dos Objetivos para um Desenvolvimento Sustentável, -ano 2015-, um esforço para parametrizar as diferentes intervenções dos Estados e das Organizações, em função de objetivos claros e interdependentes. Angola, é um país da África austral, que apresenta valores muito elevados nos índices de mortes maternas e neonatais, de tal forma que sua magnitude tornou os esforços por encontrar vias de superação, uma prioridade nacional, assim definida pelo Estado Angolano. O Centro Materno-Infantil N.ª Sr.ª da Graça, em Benguela, está integrado no universo da rede de unidades de saúde da Igreja Católica de Angola e localiza-se no seio da comunidade de um Bairro periférico de Benguela, numa Paróquia com cerca de 140.000 pessoas. Desenvolve desde há dez anos, um importante trabalho de promoção da saúde materna e neonatal, promovendo consultas de vigilância da gravidez, apoio ao parto e puerpério, pediatria, ginecologia e obstetrícia, atividades de promoção da saúde, em ambiente escolar e comunitário. Tem desde 2009, uma média de 800 partos e 1900 consultas de pré-natal, por ano. Por ser considerado um Centro de referência, quanto à qualidade dos cuidados de saúde, com números reduzidos quanto à mortalidade materna e neonatal, foi integrado num projeto com apoio internacional, de reforço das competências das enfermeiras, parteiras e gestores, das unidades de saúde, da Igreja Católica nas Províncias de Benguela, Huambo e Bié e de elementos de unidades de saúde do Estado Angolano, nas mesmas Províncias. O projeto Forvida – programa Obrigado Mãe, apoiou a adaptação do Centro, às necessidades em saúde materno-infantil, de uma população que vive nos limites da vulnerabilidade. Utilizando uma estratégia de Estudo de Caso, estudámos o Centro, procurando conhecer as razões subjacentes à reduzida taxa de Mortalidade Materna e Neonatal. Foram explorados os fatores estruturais e processuais, bem como as ações de melhoria levadas a cabo e a dinâmica de permanente cooperação com instituições nacionais angolanas e internacionais. Obtiveram-se, no final, resultados epidemiológicos da Mortalidade Materna e Neonatal, de 133/100.000 e 9/1.000,respetivamente. Estes resultados são significativamente inferiores aos aceites pelas instâncias internacionais, 477/100.000 (RMM) e 29/1.000 (MN), em 2018. A partir de 2018 e em função de alterações metodológicas no cálculo das estimativas, Angola passou a apresentar um valor de 241/100.000 (RMM) (UI:[167- 346]) e de 29/1.000 (MN). (1) Conclui-se que os resultados se ficam a dever à relevante consonância da atividade do CMI-NSG, com os Standards de qualidade para este tipo de unidades de saúde, definidos pela OMS, concretizados no modelo de gestão e na organização dos profissionais de enfermagem e médicos, do Centro, bem como na permanente ligação à comunidade envolvente. Considera-se demonstrado, ter sido possível reduzir os indicadores de Mortalidade Materna e, Neonatal, no Centro, numa situação de vulnerabilidade social, com poucos recursos económicos.
Facing the maternal and newborn mortality in the world, and namely in the underprivileged countries, is an imperative emphasized by the evidence that the causes are known and relatively simple to face, namely within the scope of the functions of nursing professionals. Maternal and Neonatal Mortality, on the one hand, and the state of development of countries and communities, on the other, are key indicators in the analysis and in the knowledge of people’s health levels, since their close interrelationship, nurtures and promotes the poverty situations which, in turn, create an obstacle to their own development. The United Nations and other international agencies with responsibility in addressing this situation, have developed, through the agenda of the Millennium Development Goals, - year 2000-, and the Goals for Sustainable Development, - year 2015-, an effort to parameterize the different interventions of States and Organizations, according to clear and interdependent objectives. Angola is a country in Southern Africa with very high rates of maternal and neonatal deaths, in such a way that its magnitude, made the efforts needed to find ways to overcome it, one of the national priorities, as defined by the Angolan state. The Centro Materno-Infantil Nª Srª da Graça, in Benguela, is a unit of the health centers network, of the Catholic Church of Angola and is located in a community of a peripheral neighborhood in Benguela, in a parish with approximately 140 000 inhabitants. For ten years, it has been carrying out important work to promote maternal and neonatal health, namely consultations on pregnancy surveillance, childbirth and postpartum support, pediatrics, gynecology and obstetrics, health promotion activities, in school and community settings. Since 2009, there have been an average of more than 800 births and 1900 prenatal consultations per year. Being considered as a reference center, in terms of the quality of health care, with reduced number of maternal and neonatal mortality, it was integrated into a project with international support, to strengthen the skills of nurses, midwives and managers, in health units of the Catholic Church in Benguela, Huambo and Bié, and of the Angolan state in the referred Provinces. Project Forvida - program “Obrigado Mãe” has supported the Center’s adjustment to the needs of the maternal and child health of a population that lives within the limits of vulnerability. Using a Case Study strategy, we have studied the Center, seeking to understand the reasons behind the reduced rate of Maternal and Neonatal mortality. The structural and procedural factors were explored, as well as the improvement actions carried out and the dynamics of permanent cooperation with Angolan and, national and international institutions. In the end, epidemiological results of Maternal and Neonatal Mortality of 133/100.000 and 9/1.000, respectively were obtained. These results are significantly lower than those accepted by international bodies, 477/100.000 (RMM) and 29/1.000 (NM), in 2018. From 2018 and due to methodological changes in the calculation of estimates, Angola started to present a value of 241/100,000 (MMR) (UI [167-346]) and 29/1,000 (NM). (1) It is concluded that the results are due to the compliance with the Quality Standards for this type of health units, defined by WHO, implemented in the management model and in the organization of nursing and medical professionals, of the Center, as well as in the permanent connection with the local community. It is considered demonstrated that it has been possible to reduce the indicators of Maternal and Neonatal Mortality in the Center, in a situation of social vulnerability, with few economic resources.
Facing the maternal and newborn mortality in the world, and namely in the underprivileged countries, is an imperative emphasized by the evidence that the causes are known and relatively simple to face, namely within the scope of the functions of nursing professionals. Maternal and Neonatal Mortality, on the one hand, and the state of development of countries and communities, on the other, are key indicators in the analysis and in the knowledge of people’s health levels, since their close interrelationship, nurtures and promotes the poverty situations which, in turn, create an obstacle to their own development. The United Nations and other international agencies with responsibility in addressing this situation, have developed, through the agenda of the Millennium Development Goals, - year 2000-, and the Goals for Sustainable Development, - year 2015-, an effort to parameterize the different interventions of States and Organizations, according to clear and interdependent objectives. Angola is a country in Southern Africa with very high rates of maternal and neonatal deaths, in such a way that its magnitude, made the efforts needed to find ways to overcome it, one of the national priorities, as defined by the Angolan state. The Centro Materno-Infantil Nª Srª da Graça, in Benguela, is a unit of the health centers network, of the Catholic Church of Angola and is located in a community of a peripheral neighborhood in Benguela, in a parish with approximately 140 000 inhabitants. For ten years, it has been carrying out important work to promote maternal and neonatal health, namely consultations on pregnancy surveillance, childbirth and postpartum support, pediatrics, gynecology and obstetrics, health promotion activities, in school and community settings. Since 2009, there have been an average of more than 800 births and 1900 prenatal consultations per year. Being considered as a reference center, in terms of the quality of health care, with reduced number of maternal and neonatal mortality, it was integrated into a project with international support, to strengthen the skills of nurses, midwives and managers, in health units of the Catholic Church in Benguela, Huambo and Bié, and of the Angolan state in the referred Provinces. Project Forvida - program “Obrigado Mãe” has supported the Center’s adjustment to the needs of the maternal and child health of a population that lives within the limits of vulnerability. Using a Case Study strategy, we have studied the Center, seeking to understand the reasons behind the reduced rate of Maternal and Neonatal mortality. The structural and procedural factors were explored, as well as the improvement actions carried out and the dynamics of permanent cooperation with Angolan and, national and international institutions. In the end, epidemiological results of Maternal and Neonatal Mortality of 133/100.000 and 9/1.000, respectively were obtained. These results are significantly lower than those accepted by international bodies, 477/100.000 (RMM) and 29/1.000 (NM), in 2018. From 2018 and due to methodological changes in the calculation of estimates, Angola started to present a value of 241/100,000 (MMR) (UI [167-346]) and 29/1,000 (NM). (1) It is concluded that the results are due to the compliance with the Quality Standards for this type of health units, defined by WHO, implemented in the management model and in the organization of nursing and medical professionals, of the Center, as well as in the permanent connection with the local community. It is considered demonstrated that it has been possible to reduce the indicators of Maternal and Neonatal Mortality in the Center, in a situation of social vulnerability, with few economic resources.
Description
Keywords
Mortalidade materna Mortalidade neonatal Angola Vulnerabilidade social Gravidez Maternal mortality Neonatal mortality Social vulnerability Pregnancy