Adequacy of prenatal care in the state of Rio de Janeiro according to the type of childbirth funding
DOI:
https://doi.org/10.11606/s1518-8787.2025059006486Keywords:
Prenatal Care, Health Evaluation, Cross-Sectional Studies, Maternal and Child Health, Healthcare Financing, BrazilAbstract
OBJECTIVE: To evaluate the adequacy of prenatal care (PNC) in the state of Rio de Janeiro (SRJ) according to the type of childbirth funding.
METHODS: A cross-sectional, hospital-based study conducted from 2021 to 2023 through interviews with postpartum women and collection and analysis of data from prenatal cards and medical records in public and private hospitals. Overall adequacy and adequacy of various PN components were estimated based on care guidelines from the World Health Organization and the Brazilian Ministry of Health, using 95% as the standard for adequacy.
RESULTS: PN coverage was 98.5%, with 98.6% of women having received a prenatal card. Among the 1,325 women with an available card, 78.8% began PNC by the 12th gestational week; 75.5% had the adequate number of consultations for gestational age at delivery; 64.7% had documentation of all first routine PN tests, and 18.9% of the second; 31.6% received adequate immunization for tetanus and hepatitis B; 29.4% received iron and folic acid supplementation; and 17.6% received counseling on delivery types, reference maternity hospital, and were asked about alcohol use and smoking. A decrease in PN adequacy was observed when all components were considered, with less than 1% of women achieving overall adequacy. Women with publicly financed births had greater social vulnerability and lower PN coverage and adequacy in terms of timing, number of consultations, tests, and counseling.
CONCLUSION: PNC was found to be inadequate in SRJ, with lower adequacy among women with public financing, who represent a group with higher social vulnerability, increasing the likelihood of adverse outcomes in this population. It is essential to develop and implement strategies to improve PN adequacy and to ensure the best care for those who need it most.
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