Cuidado neonatal em Sergipe : estrutura, processos de trabalho e avaliação dos componentes do Essential Newborn Care

Abstract

It is understood that the organization of perinatal care, according to the risk approach, implies that every pregnant and newborn are adequately cared for at the level of complexity they need. The purpose of the present study was to describe the structure and processes of care for pregnant women and newborns, including essential neonatal care, in maternity hospitals in the State of Sergipe. It is an integrated cross-sectional study to the research Born in Sergipe: survey about pre - natal, delivery and puerperium, conducted between June 2015 and April 2016 in public, mixed and private hospitals of Sergipe that had performed a minimum of 500 births in 2014, totaling 11 hospitals. Initially, a questionnaire was administered to managers of the eligible units on the existing structure and work processes. Subsequently, a representative number of postpartum women from these hospitals were interviewed and, after discharge, their medical records and those of their newborns were analyzed. The results showed that Sergipe has 78 beds of Neonatal Intensive Care Unit (NICU) and 90 Units of Intermediate Unit (UI) to meet spontaneous and programmed demand. Only six maternity hospitals (54.5%) performed the risk classification, and four (36.3%) had protocols for attending high-risk deliveries. Moreover, regarding components of the Essential Newborn Care corresponding strategies which aim to improve the health of the newborn at different stages, from conception to the postnatal period, only 18% of women had the presence of Companion always for delivery, 41% had skin-to-skin contact early with their child and 33.1% breastfed in the first hour of life. It was observed an adequate distribution of NICU beds between Capital and Interior considering the current legislation, low adherence to protocols of hypertensive and hemorrhagic emergencies; there was low coverage also for the humanization policies, risk rating for the pregnant woman and practices of Essential Newborn Care, especially the skin - to - skin contact and breastfeeding in the first hour of life.