EDITORIAL
The role of nurses in government policies to reduce maternal and neonatal morbidity and mortality
The Women's Health Division of the Brazilian Ministry of Health (2003-2006) reports stabilization in maternal deaths since 2000. The reduction of maternal deaths per 100 thousands newborns from 51.52 in 2000, 50.23 in 2001, 53.77 in 2002, and 51.74 in 2003 to 54.35 deaths(1) per 100 thousands newborns in 2004 is associated with the improvement in the Brazilian family planning and quality obstetric care. However, this number continues to be unacceptable because in developed countries the number of maternal deaths is around 6-20 deaths per 100 thousands newborns.
On the other hand, infant deaths occurring in the first year of life are associated with several perinatal factors. These primary perinatal factors are health state and nutrition, level of education and quality of life, and quality of care during the prenatal, delivery, and postpartum period. Neonatal deaths became the main component of infant death since 1990. Neonatal deaths in 2003 were 15.8 per 1000 newborns and in 2004 were 15.0 per 1000 newborns. In addition, the decrease in infant deaths from 33.2 per 10000 newborns in 1996 to 22.64 per 1000 newborns in 1004 is associated with the improvement of quality post neonatal care.
Reducing maternal and neonatal morbidity and mortality rates is challenging. To overcome these factors, there is a need of a prenatal health care plan that includes strategies to prevent vertical HIV transmission, to eradicate congenital and gestational syphilis, to eradicate neonatal tetanus, to establish a national program to motivate normal delivery and decrease unnecessary cesarean sections, promote qualified and human obstetric and neonatal care including assistance to women and teenagers during abortion.
Nursing leadership in these processes has been legally and institutionally recognized through "Documents of the Brazilian Ministry of Health (Portarias do Ministério da Saúde)" such as "Humanization in Prenatal and Delivery Program (Programa de Humanização no Pré-Natal e Nascimento)", "National Policy for Obstetric and Neonatal Care (Política Nacional de Atenção Obstétrica e Neonatal), "Nacional Agreement for the Reduction of Maternal and Neonatal Mortality (Pacto Nacional pela Redução da Mortalidade Materna and Neonatal), and National Policy for Primary Care (Política Nacional de Atenção Básica).
Considering that nurses' main role is to care for the individual, family, community, and society, establishment of nursing practice in reproductive health under the focus epidemiological and gender, requires a new knowledge and ethical role from nurses. This new knowledge must incorporate health as a right and the principles of the Brazilian Unified Health System (Sistema Único de Saúde).
REFERÊNCIAS
1. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação em Saúde. Saúde Brasil 2005: uma análise da situação de saúde no Brasil. Brasília (DF): Ministério da Saúde, 2005t. 822 p., il. (Série C. Projetos, Programas e Relatórios).
Prof. Dra. Janine Schirmer
Livre-Docente da Disciplina de Enfermagem Obstétrica
Publication Dates
-
Publication in this collection
16 Oct 2007 -
Date of issue
Sept 2007
