Quality of antenatal care in Primary Health Care in Brazil: A Latent Class Analysis-Reference-Cited by-同舟云学术

Quality of antenatal care in Primary Health Care in Brazil: A Latent Class Analysis

Published:2023-06-07 Issue: Volume: Page:
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Ortelan Naiá¹^ORCID,Flores-Quispe Maria del Pilar²^ORCID,Luz Leandro Alves da³^ORCID,Martufi Valentina⁴^ORCID,Anjos Eduarda Ferreira dos⁵^ORCID,de Lima Acácia Mayra Pereira⁶^ORCID,de Almeida Josemir Ramos²^ORCID,Passos Michelle Pereira Vale dos²^ORCID,Santos Ythalo Hugo da Silva²^ORCID,Amorim Leila Denise Alves Ferreira⁷^ORCID,Vieira-Meyer Anya Pimentel Gomes Fernandes⁸^ORCID,Ichihara Maria Yury Travassos²^ORCID,Aquino Rosana⁹^ORCID,Barreto Mauricio Lima²^ORCID,Junior Elzo Pereira Pinto²^ORCID

Affiliation:

1. Center for Data and Knowledge Integration for Health (CIDACS)/Gonçalo Moniz Institute (IGM)/Oswaldo Cruz Foundation (FIOCRUZ-BA)

2. CIDACS/IGM/FIOCRUZ-BA

3. Secretaria de Saúde do Estado da Bahia (Diretoria de Atenção à Saúde/Atenção Primária à Saúde)

4. CIDACS/IGM/FIOCRUZ-BA, Instituto de Saúde Coletiva (ISC)/Federal University of Bahia (UFBA)

5. CIDACS/IGM/FIOCRUZ-BA, Escola Nacional de Saúde Pública Sérgio Arouca (ENSP)/FIOCRUZ-RJ

6. ISC/UFBA, Departamento de Saúde Coletiva, Universidade Federal do Paraná (UFPR)

7. Instituto de Matemática e Estatística/UFBA

8. FIOCRUZ-CE

9. ISC/UFBA

Abstract

Abstract Background Adequate antenatal care (ANC) is fundamental in preventing maternal and neonatal mortality. Developing indicators for assessing the ANC quality in Primary Health Care (PHC) is essential. Objective To characterize subgroups of quality of care with respect to ANC at the PHC level in Brazil. Methods We conducted a cross-sectional study with data from the first Brazil's National Program for Improving Primary Care Access and Quality (PMAQ-AB) cycle (2012). 16,566 PHC teams participated in the first cycle of the PMAQ-AB, corresponding to 49.6% of the teams active across Brazil, distributed across 69.3% of Brazilian municipalities. To evaluate the ANC quality, six indicators were elaborated: "Medicines", "Protocols and patient flows", "Record keeping practices", "ANC routine tests", "Protocols for early detection of pregnant women and ANC provision", and "Identification and ANC of Low/High-risk pregnancies". Latent Class Analysis (LCA) was carried out to characterize the quality of care provided by PHC teams according to these six indicators. Results "Identification and ANC of Low/High-risk pregnancies" indicator had the highest percentage of teams providing adequate care (39.5%), while "ANC routine tests" had the lowest percentage (16.8%). The LCA identified three classes, and 20.5% of PHC teams had the probability of belonging to the class denominated "High adequacy". Conclusion Using a dataset from a survey carried out with health professionals at the PHC level allowed us to select indicators and characterize PHC teams in terms of the adequacy of ANC provided. This approach can guide global initiatives to evaluate the quality of ANC.

Funder

Bill and Melinda Gates Foundation

Publisher

Research Square Platform LLC

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