Banca de QUALIFICAÇÃO: Yluska Myrna Meneses Brandão e Mendes

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : Yluska Myrna Meneses Brandão e Mendes
DATE: 25/07/2023
TIME: 14:00
LOCAL: plataforma teams - link disponível na página do programa
TITLE:

“ Obstetric care in Brazil: a study based on the Robson classification ”

KEY WORDS:

“Cesarean section; Teaching Hospitals; Program evaluation; Robson classification; Brazil ”

PAGES: 1000
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

“Rede Cegonha (RC) was established in 2011, in Brazil, to improve care and promote adequate delivery care in a humanized way. However, the technocratic model still persists and continues to be adopted in Teaching Hospitals (TH). To address this problem, the Parto Adequado project was desgned in 2015, aiming to support the reduction of unnecessary cesarean in the context of supplementary health and, in 2017, the Improvement and Innovation in Care and Teaching in Obstetrics and Neonatology project (Apice ON) was instituted with the purpose of transforming the model of obstetric and neonatal care in HT, through changes in training, care and management of health services. Cesarean rates are increasing all over the world. Although the World Health Organization (WHO) argues that the ideal cesarean rate should not exceed 15% of all births, in 2020, Brazil had an average proportion of 57%, standing out with one of the highest rates observed in the world. Government efforts to reduce unnecessary cesarean sections are being adopted, maintaining those that are indicated and can save lives, reducing maternal and neonatal mortality. The Robson Classification has been recommended by the WHO as the most appropriate reference for assessing, monitoring and comparing cesarean rates over time, in the same scenario and between different scenarios. The Robson Classification uses obstetric characteristics to construct 10 epidemiological risk groups. The Information System on Live Births (Sinasc) includes, since 2011, the information necessary for stratifying of the 10 Robson groups and identifying unnecessary cesarean sections. Faced with this problem, the question of this research is: what is the scenario of unnecessary cesarean sections in Brazilian hospitals, based on the application of the Robson Classification on data from the Apice ON and Parto Adequado projects? The general objective of this research is to evaluate the changes that occurred in the profile of cesarean sections in the hospitals participating in the Apice ON and Parto Adequado projects, based on the Robson Classification. The specific objectives are: i) to describe structural and practical changes and the evolution of cesarean sections, according to the Robson Classification, in the hospitals participating in Apice ON; ii) to investigate the changes that occurred in the profile of cesarean sections in the hospitals participating in the Apice ON project during the Covid-19 pandemic; iii) to characterize the changes introduced in the hospitals participating in the Parto Adequado project on the evolution of cesarean sections, according to the Robson Classification. At first, an evaluative research of the before-after type will be carried out, with a quantitative, retrospective and cross-sectional approach, with data collected and systematized by Sinasc, CNES and SIH/SUS. The bases of the first half of 2017 and second half of 2019 will be investigated. Next, an evaluative research will be carried out, of the before-after type, with a quantitative, retrospective approach, with data collected from Sinasc, from the years 2019 and 2021. finally, a descriptive, longitudinal, retrospective study will be developed, with Sinasc's secondary database, referring to the years 2014 and 2019, on the hospitals included in the Parto Adequado and Apice ON initiatives. It is expected to contribute to the discussion on the improvement of childbirth care in Brazil and in the world."

COMMITTEE MEMBERS:
Externa à Instituição - CARMEN SIMONE GRILO DINIZ - USP
Externa à Instituição - ANA MARIA MALIK - FGV
Presidente - ***.907.758-** - DAPHNE RATTNER - UnB
Interno - 1041337 - IVAN RICARDO ZIMMERMANN
Externa à Instituição - LEILA POSENATO GARCIA - UnB