Avaliação da implantação da atenção humanizada ao recém-nascido de baixo peso método Canguru, no Brasil

Abstract

Introduction:Kangaroo Care (MC) was introduced in Brazil by itsown initiative in some hospitals in the late 90s. Thereafter the Ministry of Health (MOH) began extensive process to its dissemination through training of professionalsin nurseries in Brazil, with the aim of encouraging the expansion and improvement of the quality of obstetric and neonatal care in the public sector. This training program was aimed at achieving the 255 hospitals that are part of the System Support Maternity Hospital. Objective:To evaluate the implementation of the Humane Newborn underweight - Kangaroo Care in Brazil in maternity trained until 2003. Method:It is based on the evaluation study normative assessment and the use of methods that integrate quantitative and qualitative aspects. We analyzed the 293 maternity hospitals trained by MS to implement the Kangaroo Care in Brazil from2000 to 2003. This study was divided into two phases. The first consisted of the evaluation of all maternities trained, by sending a postal questionnaire addressed to the coordinator of this practice or neonatal unit, containing issues: a) the structure of maternity b) assessmentpractices humanization c) results achieved with the implementation of humanized care to low birth weight newborn - Kangaroo Care. In this phase we used the statistical program Statistical Package for the Social Sciences (SPSS) 16.0. The second phase consisted of the evaluation "in situ" sample of these hospitals, where they were applied various data collection instruments targeted at professionals, managers and mothers. At that stage it was used for qualitative analysis of the material collected in the interviews, the structural analysis of narrative, based on Grounded Theory. This study meets the ethical principles of Resolution 196/96, the National Board of Health and was approved by the Ethics Committee of UFMG. Results: The results showed that the training of professionals maternity brasilieras for deploying Kangaroo Care was important to start the process, however, did not reach the level of induction enough to change practice, especially in the second and third steps of the method. We also identified that the implementation of all phases of the MC was associated with the presence of human milk bank and be public hospital. Regarding the qualitative approach to discourse analysis allowed us to state that, in the different regions of the country, there was agreement on the representations of mothers, managers and health professionals in maternity hospitals about the importance of parent and family as an active part in the recovery process Newborn risk brought about by Kangaroo Care. Conclusion:We conclude that there are still huge challenges such as the need for greater institutional support, improving the physical structure, organizational resources and personnel to be faced for the Kangaroo method becomes a powerful tool in health care for the newborn underweight in Brazilian hospitals.