Navegando por Palavras-chave "Infant Mortality"
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- ItemSomente MetadadadosAspectos obstétricos da prematuridade: Ensaios clínico e de revisão(Universidade Federal de São Paulo (UNIFESP), 2000) Souza, Eduardo de [UNIFESP]; Universidade Federal de São Paulo [UNIFESP]
- ItemAcesso aberto (Open Access)Educação permanente e a redução da mortalidade infantil em um município do Grande ABC – SP: um estudo de caso(Universidade Federal de São Paulo (UNIFESP), 2019-10-04) Walendy, Claudia Helena [UNIFESP]; Nicolau, Stella Maris [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Combating child mortality is a challenge for societies wishing to improve their social development indicators. This study aimed to analyze how the Municipal Health Secretariat of Mauá, SP, carried out between 2013 and 2016 a successful administrative reform in relation to the reduction of child mortality, listing this issue as a priority, with continuing education actions with emphasis on changes. of work processes with a strong sense of responsibility and intense articulation of management collectives, teams among themselves and among the various services and levels of attention of the health network. This is a case study with documentary analysis of reports and municipal ordinances related to actions to reduce child mortality, interviews with managers and health professionals who worked in the maternal child care network during this period. The results indicate that professionals report this experience as remarkable and enriching, and that even after the completion of this management, some work processes implemented were maintained, but without the same strong network articulation promoted by management. On the other hand, there are also reports of excessive pressure for results and care actions had a strong component of control over the lives of pregnant women by the teams in order to reduce child mortality.
- ItemSomente MetadadadosEpidemiologia dos óbitos neonatais hospitalares associados à asfixia perinatal em Maceió, Alagoas, 2009(Universidade Federal de São Paulo (UNIFESP), 2010-11-24) Oliveira, Junko Asakura Bezerra de [UNIFESP]; Almeida, Maria Fernanda Branco de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Alagoas has the highest infant and neonatal mortality rates among all the States of Brazil and thus it urges to know its determinants. Aim: to describe the epidemiology of neonatal mortality associated with asphyxia in public maternity hospitals, besides the infra-structure of neonatal assistance, in Maceió, capital of Alagoas State, in 2009. Methods: This is a cross-sectional study with daily active search for medical records of mothers and their newborns who died under 28 days of age in 8 public maternity hospitals in Maceió, from Jan/1st until Dec/31st 2009. Death was considered associated with asphyxia if, at least, one criteria was present: Apgar score <6 at 5 minutes; meconium aspiration syndrome (MAS); hypoxic-ischemic encephalopathy; Apgar score <3 in the 1st minute with ventilation at birth; death record of hypoxia/asphyxia at birth. Patients with major malformations, birth weight <400g or gestational age <22 weeks were excluded. Descriptive analysis of patients included the variables of location and condition of birth and death, morbidity and therapeutic interventions. Information on physical structure, material and human resources were collected from hospitals in March and September/09. Results: In 2009, in the eight public maternity hospitals 20860 babies were born and there were 326 neonatal deaths, of which 243 (74%) were preventable. Asphyxia was present in 113 (46%) cases, of which 15 died without intensive care and 24 came from others institutions. Out of 113 deaths, 12 did not receive any resuscitation procedures and nine of them were 22-27 weeks old. Out of 86 low birth weight newborns, 79 (92%) were born with obstetrician and pediatrician care, 75 (87%) developed respiratory distress syndrome, 41 (48%) received surfactant and 41 had neonatal sepsis. Ten (37%) of the group with birth weight >2500g (27 newborns) were born without obstetrician nor pediatrician care and 17 (68%) had meconium aspiration syndrome. Regarding the interventions, 7 did not receive mechanical ventilation, 19 (70%) received aminas and only 2 had monitored blood pressure. Out of 113 deaths, 42% died before 24h and 42% between 2 and 6 days after birth. The death registration referred asphyxia in 37% of the cases and necropsy was performed in 4 cases. In the eight public maternity hospitals, where there were born 1 to 12 newborns, the number of resuscitation tables ranged from 1 to 3. Four public maternities had physical infrastructure, material and equipment for neonatal resuscitation in the delivery room. There were pediatricians all the time in seven maternities; 62% of the pediatricians attended a neonatal resuscitation course in the last two years. Out of the nursing staffs, 49% attended to the course, but one staff had never attended one. The physical infrastructure, material and equipment did not change along the year. Conclusion: In the City of Maceio, in 2009, asphyxia at birth was presented in half of the neonatal death in-hospital. In the majority of the cases there were pediatricians in the delivery room, mainly in the low birth weight cases. There were neonatal deaths in intermediate care units, and it shows the frailty of physical infrastructure and equipments, associated to the severity at birth.