Quality and equity in antenatal care and during delivery in Criciúma, Santa Catarina, in Southern Brazil

This population-based cross-sectional study was carried out with a sample of 2,180 children less than three years old living in the urban area of Criciúma, Santa Catarina State, in Southern Brazil. The study aimed to evaluate equity issues related to the quality of antenatal care and newborn care during delivery. 96.6% of mothers had at least one medical check-up during antenatal care. Almost all deliveries took place in a hospital. Low-income mothers began antenatal care later and had less medical check-ups. Pregnant women with higher reproductive risk scores received less appropriate care in the period. Among 13 recommended procedures for antenatal care and during delivery, mothers belonging to the first and quarter quartiles received 8.6 and 9.4 of the recommended procedures, respectively. Pelvic and breast examinations were the least frequently performed of all recommended procedures (51%). Women in the highest income quartile were 1.5 times more likely to have a pelvic exam, and 1.9 times more likely to have their breasts examined, than those in the lowest quartile. Health services should focus on the poorest and highest risk pregnant women. Doctors and health workers should be trained and motivated toward this purpose.

Child; Pregnant women; Equity; Primary health care; Evaluation of services; Antenatal care; Health service evaluation