Authors
Abstract
Objectives: Describe the Factors of health services and users’ satisfaction associated to the access to antenatal care (AC) at health institutions in Manizales and Cali. Materials and Methods: Case-control case study with a sample of pregnant women attending the AC in seven centers. A questionnaire was applied to 823 pregnant women to collect information. Another questionnaire was applied to four nurses in charge of the AC programs. The dependent variable was the access to the AC and the independent variables were the presence of administrative, economic, and geographic barriers, and perception of care, guidance provided and the physical appearance of health services. The variables that queried about active search strategies were: the proportion of pregnant women registered in the first trimester, use of brochures or posters raise awareness of timely access to AC. Results: Factors such as ethnicity (P = 0.01), the type of health insurance (P = 0.001), activity of the mother in the last month (P = 0.04), low economic capacity (P = 0.038), not being Affiliated to any health system (P < 0.001) and paperwork (P = 0.003) had significant differences between the groups. Both groups had positive opinions about treatment, counseling and physical appearance of health services. Conclusions: Aspects such as the decreased spending, the inconvenience arising from the care and facilities, in addition to good treatment, respect, empathy with pregnant women should be part of plans for the improvement of the quality of care of the AC.
References
Ural S, Cox C, Blakemore K, Pressman E, Bienstock J. Lack of prenatal care increases the rate of recurrent preterm delivery and health care costs when compared to university hospital-based prenatal care. Primary Care Update for OB/GYNS. 1998; 5(4):177-178.
Mrisho M, Obrist B, Schellenberg J, Haws R, Mushi A, Mshinda H, Tanner M, Schellenberg D. The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania. BMC Pregnancy and Childbirth. 2009, 9:10.
Chakraborty N, Islam M, Chowdhury R, Bari W. Utilisation of postnatal care in Bangladesh: from a longitudinal study. Health & Social Care in the Community. 2002; 10(6):492-502.
WHO, UNICEF. Antenatal Care in Developing Countries: Promises, Achievements and Missed Opportunities: An Analysis of Trends, Levels, and Differentials: 1990-2001. Geneva and New York: WHO & UNICEF; 2003.
Villar J, et al. For the WHO Antenatal Care Trial Research Group. WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. The Lancet. 2001; 357:1551-1564.
Departamento Nacional de Planeación. Dirección de Desarrollo Social. Estado de avance en el cumplimiento de los ODM – Conpes Social 91. 2005.
Profamilia. Salud Materno Infantil. Salud Sexual y Reproductiva en Colombia Encuesta Nacional de Demografía y Salud - Resultados. Bogotá: Profamilia; 2010. p. 4-5.
R.E Rowe, J Garcia, L.L Davidson. Social and ethnic inequalities in the offer and uptake of prenatal screening and diagnosis in the UK. Public Health - April 2004. Vol. 118, Issue 3, Pages 177-189.
Carter M. Husbands and maternal health matters in rural Guatemala: wives’ reports on their spouses’ involvement in pregnancy and birth. Social Science & Medicine. 2002; 55(3):437-50.
Simkhada B, van Teijlingen E, Porter M, Simkhada P. Factors affecting the utilisation of antenatal care in developing countries: systematic review of the literature. Journal of Advanced Nursing. 2008; 61(3):244-60.
Matsumura M, Gubhaju B. Women’s status, household structure and the utilisation of maternal health services in Nepal. Asia-Pacific Population Journal. 2001; 16(1):23-44.
Nielsen B, Hedegaard M, Liljestrand J, Thilsted S, Joseph A. Characteristics of antenatal care attenders in a rural population in Tamil Nadu, South India: A community-based cross-sectional study. Health & Social Care in the Community. 2001; 9(6):327-333.
Overbosch G, Nsowah-Nuamah N, Van den Boom G, Damnyag L. Determinants of antenatal care use in Ghana. Journal of African Economies. 2004; 13(2):277-301.
Aday L, Andersen R. Marco teórico para el estudio del acceso a la atención médica. In: White K, editor. Investigaciones sobre servicios de salud: una antología. Washington: Organización Panamericana de la Salud; 1992. p. 604-13.
Arias I, Palomino A, Osorio S. Mejoramiento continuo de la atención prenatal y su impacto en la mortalidad perinatal en dos instituciones de salud de Popayán. Revista Colombiana de Obstetric
Profamilia. Características generales y situación de las mujeres en edad fértil. Encuesta Nacional de Demografía y Salud. Bogotá: Profamilia; 2010 [citado 19 Oct 2013]. Disponible en: http://www.profamilia.org.co/encuestas/Profamilia/Profamilia/images/stories/PDF-capitulos/Capitulo-4.pdf
Pierre A, Gilbert Saint-Jean G, Crandall L, Fevrin E. Prenatal care utilization in rural areas and urban areas of Haiti. Revista Panamericana de Salud Pública. 2005; 18(2):84-92.
Carvacho I, Brito de Mello M, Morais S, Pinto J. Fatores associados ao acesso anterior à gestação a serviços de saúde por adolescentes gestantes. Rev Saúde Pública. 2008; 42(5):886-94.
Aguado L, Girón L, Osorio A, Tovar L, Ahumada J. Determinantes del uso de los servicios de salud materna en el Litoral Pacífico Colombiano. Revista Latinoamericana de Ciencias Sociales, Niñez y Juventud [Internet]. 2007 [citado Oct 2013]; 5(1):3-9. Disponible en: http://revistaumanizales.cinde.org.co/index.php/Revista-Latinoamericana/article/view/294/161
Eslava J, Hernández A, Ruiz F. Acceso a los servicios de salud para la población afiliada al régimen subsidiado y los participantes vinculados del nivel III de Sisbén de catorce localidades de Santa Fe de Bogotá. 2000. Convenio Universidad Javeriana - Secretaría Distrital de Salud. Bogotá.
Faneite P, Rivera C, Rodríguez F, Amato R, Moreno S, Cangemi L. Consulta prenatal: Motivos de Inasistencia, ¿se justifica? Rev Obstetricia y Ginecología Venez. 2009; 69(3):147-151.
Wilcox L, Marks J, eds. CDC’s Public Health Surveillance for women, infant and children. From data to action. US Department of Health & Human Services. Public Health Service. Center for Disease Control and Prevention, 1994: 105-1
Brockerhoff P, Seufert R. Casper F. Quality of pregnancy screening in high nsk pregnancies. What can be improved? Abstract 14 European Congress of Pennatal Medicine. Helsinki, Finland, 1994.
Departamento Administrativo Nacional de Estadísticas DANE. Departamento Nacional de Planeación. MESEP / Misión para el Empalme de las Series de Empleo, Pobreza y Desigualdad, resultados cifras de pobreza, indigencia y desigualdad 2009. Bogotá, 2010.
Colombia. Ministerio de Salud. Dirección general de promoción y prevención. Norma técnica para la detección temprana de las alteraciones del embarazo; 2000.
Sánchez R, Pérez G, Pérez P, Vázquez F. Impacto del Control prenatal y su impacto en la morbilidad y mortalidad neonatal. Rev Med Inst Mex Seguro Soc. 2005; 43(5):377-380
Seclen-Palacín J, Benavides B, Jacoby E, Velásquez A, Watanabe E. ¿Existe una relación entre los programas de mejora de la calidad y la satisfacción de usuarias de atención prenatal?: experiencia en hospitales del Perú. Rev Panam Salud Pública/Pan Am J Public Health. 2004; 16(3).
Bronfman-Pertzovsky M, López S, Rodríguez C, More A, Rutstein S. Atención prenatal en el primer nivel de atención: características de los proveedores que influyen en la satisfacción de las usuarias. Salud Pública México. 2003; 45:445-54.
Vélez C, Gómez D, González M. Errores o equivocaciones por acción u omisión en acciones de promoción y prevención dirigidas a gestantes en Manizales, 2007. Hacia la Promoción de la Salud. 2008; 13:61-76.
Carroli G, Rooney C, Villar J. How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence. Paediatr Perinat Epidemiol. 2001; 15(Suppl1):1-42.
Ramírez M, Richardson V, Ávila H, Caraveo V, Salomón R. La atención prenatal en la ciudad fronteriza de Tijuana, México. Revista Panamericana de Salud Pública [Internet]. 2000 [citado 19 Abr 2014]; 7(2):97-100. Disponible en: http://www.scielosp.org/pdf/rpsp/v7n2/1244.pdf
Almeida SD de M, Barros MB de A. Equidade e atenção a saúde da gestantes em Campinas (SP) Brasil. Revista Panamericana de Salud Pública. 2005; 17(1):15-25.
Coimbra L, Silva A, Gochel E, Alves M, Ribeiro V et al. Fatores associados á inadequação do uso da assistência pré-natal. Rev. Saúde Pública. 2003; 37(4):456-62.
Ovretveit J. Evaluating Health Intervention. Open University Press. Buckingham, Philadelphia: Blackwell Scientific; 1998.