NEONATAL PUBLIC HEALTH POLICY Fossari, Marcio Molinari, Silvana Dos Santos, Roberta Reiser, Karina City of Itajaí - BRA
NEONATAL CARE
Exploring the Possibilities towards Better Healthca
THE CITY
We have 205.271 habitants
A average of 2.991 live births/year
About 2.400 in the Public Maternity
It´s a port town City
It has a human development index of 0,795 3rd in the province
We have about 76% of the City total Area cover by the Family Health Strategy and divided in the micro-areas.
The Family Health team has at least one nurse, one medical doctor and a community health worker (variable about the number of people)
http://cod.ibge.gov.br/232T9 http://dab.saúde.gov.br
CHILD < 1Y MORTALITY 2010-201 25 20
[VALOR]
22
22
dez-12 22 7 10
dez-13 22 11 19
19
15 10 5 0 Early Neonatal Late Neonatal After Neonatal
dez-10 18 3 9
dez-11 19 13 12
CHILD < 1Y MORTALITY 20102013 10
12
9
19 7
3 13
11
[VALOR]
22 19
2010
22
2013
2012
2011 Early Neonatal
Late Neonatal
After Neonatal
700
CHILD < 1Y MORTALITY 20102013 DEATHS 52
2013
44 2011
39
2012
30 2010
2900 Total live births
31
CHILD < 1Y MORTALITY 20092013 Mortality Rate
17 15.2
3.3
09
12.8 10.9
2010
2011
2012
20
CHILD MORTALITY < 1YEAR 2013
The second highest rate of child mortality from the province One of the largest number of child death from the province A fickle line of child mortality The oscilatory curve demonstrates increase and decrease in mortality rate by chance, and not associated to an efficient Public Health Policy
It`s a surprise ?
RESOURCE
RESULTS
We’ve been here in the past. We have to care our children in their homes !!!
WHICH ARE THE PILLARS TO ADEQUATE HEALTH CARE
SURVEILLANCE
Public health surveillance is the continuous, systematic collection, analysis an
interpretation of health-related data needed for the planning, implementation, an
evaluation of public health practice. (WHO)
We have a systematic collection of data (a lot of manual work), but We were n
efficient at analysis and interpretation.
We were not anticipating the healthcare processes. (Very Important !!).
http://www.who.int/topics/public_health_surveillance/en
kind of care We ?
CARE
me visit based care Mother care and baby care eastfeeding empowerment
more than 7 days to do the visit
er if the community health worker t go alone have to be with the
se or the community doctor or both.
WHO technical consultation on newborn health indicators: Every Newborn A Plan Metrics
We have to support our teams We must be prepared for the needs at We have and support them We need to evaluate and think about e strategy often We have to give conditons for the roperly work of our teams
SUPPOR T
Advanced Level Intermediate Level Primary Level
Preventive Care in all Levels
o We Start ?
e began talk with the largest working
oup in the public health, the community
Evaluate
Action
Action
Reevaluate
alth worker, and the nurses, most of
n are the supervisors from the health
ilities at primary care.
al about 300 people.
e talk with all comumunity medical
ctors about the numbers of mortality.
ATTENTIVE CARE X THERAPEUTIC CARE
e were worried about a attentive care,
Breastfeeding
Screening tests
Mother/Baby
ore about the visit at home for the
other and the baby and less about a
edical appointment.
e tried thinking about a integrative
re and more of it, a care with
sponsability, like to care about the
other and the baby.
Jaundice
Desnutrition
say ?
en We look for the very brief ile from the mothers in 2013, don’t found a social erminant for the number of natal death.
Features 28.2 26.7 25.14 23.2
need to measure and uate the expected results, tried to antecipated them. 1.2
1.1
2013
2014
Mother Age
Number of Children
Weeks at Birth
A CARE MOVEMENT
renatal Care Breastfeeding Empowerment Diabetes Maternal Nutrition Maternal Hypertension Urinary tract Infection Syphilis
Intrapartum care
Home care
• Attendant skilled health staff • The Golden hour • The father together or someone from the Family • Newborn measures and physical examination after 1 hour
• Start at the Hospital • No more than 7 days • Look for some risk factor • Child log book • Nurse or Medical Vis (same of prenatal care)
A CARE MOVEMENT N THE CITY ??
World breastfeeding week (40%) World Health day First walk of breastfeeding A municipal “law” for support breastfeeding actions
Better information (computers in all health facility)
CHILD <1Y MORTALITY 2013-2014 < 7 days
25
20
7- 27days
28 - 1year
2013
2014
22 19
19
15
10
12
11
5 2
0 som 52
som 33
CHILD < 1Y MORTALITY 2010-201 25
22 20
[VALOR]
22
19
19
15 10 5 0 Early Neonatal Late Neonatal After Neonatal
dez-10 18 3 9
dez-11 19 13 12
dez-12 22 7 10
dez-13 22 11 19
dez-14 19 2 12
CHILD < 1Y MORTALITY 2010-201 Mortality Rate
17.3 15.2
3.3
09
12.8
10 10.9
2010
2011
2012
2013
20
700
CHILD < 1Y MORTALITY 2010-201 DEATHS 52 2013
44 2011
39
33
2012
30
2014
2010
2800
2900
3000
3100
Total live births
3200
3300
34
WE MUST CONTINUE !! • We believe that the set of all actions and not just one or the other has been essential for improved results.
• We need to get a better result for the neonatal early deaths • We have to improved a lot our prenatal assistance • We must to continue all the actions and have more patterns for help • Invest in education for all !!
THE CITY HALL AND OUR TEAM
OUR FAMIL
