In Brazil, despite the improvements that have occurred in the health of mothers and children, indicators of maternal and neonatal mortality are still far from desirable. To reverse this situation, it is important to rethink the process of work, considering the hospital and perinatal care network planning, and focus on institutional democratization. This study aimed to discuss the process of application of the "strategic demarche" approach in a State public maternity with a view to coordinated network of services. The period was from June to September 2009 and included the direct participation of professionals / stakeholders, including the hospital board. The results showed the method's ability to question the work processes and the analysis of hospital management. Based on the analyses, the experience pointed action strategies validated by different actors. The method can be considered innovative and effective to produce more cohesive health teams and co-responsible with changing practices movements. It allowed the creation of communication channels between maternity professionals, and between these actors and the external network. The study showed the potential of the approach as a tool for situational analysis and hospital management to review the institutional mission in search of quality and solidarity within the network, committed to attend users in a universal and equitable way. However, the commitments expressed in the propositional synthesis must be constantly reviewed and renegotiated by the actors, in order to achieve permanent institutional changes.
Public Health; strategic management; health planning; humanization; child and mother health care
