Primary Care and Obstetric Center in the Western Health Region of the Federal District: developments of a brief situational diagnosis.

Abstract

Introduction: Primary care is the gateway to the SUS and is responsible for building the bond and longitudinality of care with users, regardless of their health condition. Women's health, as a line of care, permeates not only the primary level, but the entire health care network, such as polyclinics, hospitals, diagnostic and imaging centers and maternity hospitals. In this sense, a pregnant woman must be accompanied throughout pregnancy and after the birth of the baby, through prenatal care, performed at the Basic Health Unit (UBS), and childbirth and puerperium, performed at the Obstetric Centers (OC) and Maternities. In this report, I present the consequences of a brief situational diagnosis carried out in the western health region of the Federal District (DF), based on the care provided at the UBS's and the care provided at the Obstetric and Maternity Center of the Regional Hospital of Ceilândia (HRC). Objective: To explain how the relationship between primary care and hospital care affects care for pregnant, parturient and postpartum women in the Western health region and what is the impact of this care on the care provided before, during and after childbirth. Method: This is an experience report based on a brief situational diagnosis carried out based on the experience of 32 users inserted in the spaces of the CO and Maternity of the HRC, as well as with the managements of Primary Care and the Obstetric Center, in the November 2020. A form was applied to pregnant, parturient and postpartum women with the objective of reporting their experience as a user of Primary Care and Hospital Care. For the managements, debates were held between the management of each level of care to identify the bottlenecks of their teams, how this affected the service and what actions could be taken. Results: Among the main findings of this diagnosis, the following stand out: lack of completion of the pregnant woman's booklet by the reference UBS, perception of fragility in the practice of humanization in care; absence of medical professionals and health education actions during prenatal care; duplicate use of supplies due to lack of information records; and lack of integration between Primary Care and Hospital Care, diverging from the principle of longitudinality of care. As a referral, after consolidating the findings, meetings were held to discuss the results and survey the actions to be taken. Both the management of the OC and Maternity of the HRC and the management of Primary Care listed necessary and urgent points to intervene, each one at its level of care, encouraging the fulfillment of resolute actions and better health planning. Conclusion: These results revealed that the actions carried out in primary care, or the absence of them, directly impact the care provided in hospital care. The absence of information recording can cause errors during the care process. Attention to the longitudinality of care is a basic premise for strengthening the SUS and improving the care provided to users at any level of care.