Strengths and weaknesses in the high-risk baby care network

Cardilli-Dias, Daniela; Stoianov, Maristela; Santos, Thaís Helena Ferreira; Molini-Avejonas, Daniela Regina

doi:10.1590/1980-220X-REEUSP-2022-0150en

Brasil

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Original Article • Rev. esc. enferm. USP 57 • 2023 • https://doi.org/10.1590/1980-220X-REEUSP-2022-0150en linkcopy

Strengths and weaknesses in the high-risk baby care network

Fortalezas y debilidades en la red de atención al bebé de alto riesgo

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To characterize the Stork Network in health care for high-risk babies, pointing out its main challenges.

Method: questionnaires were applied with those responsible for the babies and with network health professionals. Data were analyzed quantitatively.

Results: statistically relevant variables were: link with the Basic Health Unit; individuals’ awareness of Family Health Support Center team; awareness of Family Health teams regarding the diagnosis of high-risk pregnancy and compliance with prenatal care; means of communication of individuals’ birth; awareness of the need for hospitalization as well as its duration; awareness of follow-up in Secondary Health Care; and its outcome, pointing to a difficulty in the axis of coordination and longitudinality of the services provided in the network.

Conclusion: the greatest challenges lie in covering the territory by Family Health strategy teams, expanding teams and solidifying partnerships with Higher Education Institutions, guaranteeing a differentiated professional training.

DESCRIPTORS Maternal and Child Healt; Child Healt; Health Service; Public Healt; Health Care Level; Child Development

Variables	User	Professional	p
Is linked to BHU	N = 22	N = 22	0.004
Yes	12 (54.5%)	14 (63.3%)
No	10 (45.5%)	3 (13.6%)
DNKA	0 (0.0%)	5 (22.7%)
Know NASF team	N = 22	N = 22	0.001
No	19 (86.4%)	8 (36.4%)
DNKA	0 (0.0%)	4 (18.2%)
Yes/knows	1 (4.5%)	0 (0.0%)
Yes/used	2 (9.1%)	10 (45.5%)
Professional who referred to RPN	N = 9	N = 10	0.014
Nurse	5 (55.6%)	1 (10.0%)
Doctor	4 (44.4%)	5 (50.0%)
Doctor/nurse	0 (0.0%)	4 (40.0%)

Variables	User	Professional	p
Where puerperal follow-up took place	N = 22	N = 22	<0.001
PHC	4 (18.2%)	15 (68.2%)
SHC	2 (9.1%)	2 (9.1%)
PHC/SHC	16 (72.7%)	4 (18.2%)
DNKA	0 (0.0%)	1 (4.5%)
There was referral to SHC	N = 22	N = 22	<0.001
Yes	14 (63.6%)	11 (50.0%)
No	8 (36.4%)	3 (13.6%)
DNKA	0 (0.0%)	8 (36.4%)
Referral mode	N = 14	N = 11	0.046
Referral and scheduling	13 (92.9%)	8 (72.7%)
Referral	1 (7.1%)	0 (0.0%)
DNKA	0 (0.0%)	3 (27.3%)
Other referral to SHC	N = 8	N = 14	0.028
Yes	8 (100%)	7 (50.0%)
No	0 (0.0%)	0 (0.0%)
DNKA	0 (0.0%)	7 (50.0%)
Duration of service	N = 22	N = 22	<0.001
Up to 3 months	5 (22.7%)	1 (4.5%)
> 3 months < 1 year	5 (22.7%)	2 (9.1%)
> 1 year	12 (54.5%)	2 (9.1%)
DNKA	0 (0.0%)	17 (77.3%)
Awareness of attendance or absence at SOC	N = 22	N = 22	0.001
Yes	19 (86.4%)	11 (50.0%)
No	3 (13.6%)	4 (18.2%)
DNKA	0 (0.0%)	7 (31.8%)
Awareness mode of FHt	N = 19	N = 11	0.005
PHC	3 (15.8%)	4 (36.4%)
Family	16 (84.2%)	7 (63.6%)
Attendance at 1^st service at SOC	N = 22	N = 18	< 0.001
Yes	22 (100.0%)	10 (56.6%)
No	0 (0.0%)	4 (22.2%)
DNKA	0 (0.0%)	4 (22.2%)
There was another absence	N = 22	N = 18	< 0.001
Yes	12 (54.5%)	2 (11.1%)
No	10 (45.5%)	0 (0.0%)
DNKA	0 (0.0%)	16 (88.9%)
There was awareness by FHt for compliance	N = 22	N = 18	< 0.001
Yes	12 (54.5%)	8 (44.5%)
No	10 (45.5%)	4 (22.2%)
DNKA	0 (0.0%)	6 (33.3)
There was rescheduling for SOC	N = 12	N = 2
Yes	7 (31.8%)	1 (50.0%)	< 0.001
No	3 (59.1%)	1 (50.0%)
Abandonment	2 (9.1%)	0 (0.0%)
DNKA	0 (0.0%)	0 (0.0%)
There was a search for other health equipment	N = 22	N = 18	< 0.001
Yes	4 (18.2%)	4 (22.2%)
No	18 (81.8%)	4 (22.2%)
DNKA	0 (0.0%)	10 (55.6%)

Variables	User	Professional	p
There is ISA between PHC and SHC	N = 22	N = 10	<0.001
Yes	7 (31.8%)	4 (40.0%)
No	10 (45.5%)	4 (40.0%)
DNKA	5 (22.7%)	2 (20.0%)
There is need for ISA between PHC and SHC	N = 15	N = 6	0.004
Yes	14 (93.3%)	6 (100.0%)
No	0 (0.0%)	0 (0.0%)
DNKA	1 (6.7%)	0 (0.0%)
ISA time between PHC and SHC	N = 7	N = 4
> 1 year	0 (0.0%)	3 (75.0%)	<0.001
DNKA	7 (100.0%)	1 (25.0%)	<0.001
ISA between PHC and SHC is functional	N = 7	N = 4	<0.001
Yes	7 (100.0%)	2 (50.0%)
No	0 (0.0%)	2 (50.0%)
DNKA	0 (0.0%)	0 (0.0%)
There is ISA between PHC and THC	N = 22	N = 10	<0.001
Yes	1 (4.5%)	0 (0.0%)
No	10 (45.5%)	8 (80.0%)
DNKA	11 (50.0%)	2 (20.0%)
Knows the attributes of network professionals	N = 22	N = 10	<0.001
Yes	8 (36.4%)	9 (90.0%)
No	14 (63.6%)	1 (10.0%)
DNKA	0 (0.0%)	0 (0.0%)
The care network is functional	N = 22	N = 10	<0.001
Yes	18 (81.8%)	2 (20.0%)
No	3 (13.6%)	5 (50.0%)
DNKA	1 (4.5%)	3 (30.0%)
Network is of quality	N = 22	N = 10	<0.001
Yes	18 (81.8%)	3 (30.0%)
No	4 (18.2%)	4 (40.0%)
DNKA	0 (0.0%)	3 (30.0%)

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Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
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[T1FN1] BHU – Basic Health Unit, NASF – Family Health Support Center, RPN – high-risk prenatal care.