Quality of newborn healthcare in the first week of life in Brazil’s primary care network: a cross-sectional multilevel analysis of the National Programme for Improving Primary Care Access and Quality – PMAQ

Abstract

ObjectiveTo estimate the prevalence of good quality child care in the first week of life in primary care services in Brazil and identify associated factors related to maternal, primary healthcare (PHC) facility and municipality characteristics.SettingBrazilian PHC.Participants6715 users of PHC facilities aged over 18 years with children under 2 years of age.Primary outcomeThe good quality child care was defined when the following health interventions were performed during postnatal check-up in the first week of life: the child was weighed and measured; the healthcare professional observed breastfeeding techniques and offered counselling on the safest sleeping position; the umbilical cord was examined and the heel prick test was performed.ResultsThe prevalence of good quality care was 52.6% (95% CI 51.4% to 53.8%). Observation of breastfeeding techniques (75.9%) and counselling on the safest sleeping position (72.3%) were the activities least performed. Babies born to mothers who received a home visit from a community health worker and made a postpartum visit were twice as likely to receive good quality care (OR 1.96; 95% CI 1.70 to 2.24 and OR 1.97; 95% CI 1.74 to 2.24, respectively).ConclusionsThe information reported by the mothers related to Family Health team work processes was associated with good quality care in the first week of life. Supporting strategies that strengthen health team active search and timely screening actions could promote adequate early childhood development.

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“…Among the 10 articles accepted, two articles were intervention studies (randomized controlled trials/RCT) (Luger et al, 2016;Mirmolaei et al, 2014), two articles were cross-sectional studies (Flores-Quispe et al, 2022;Nsibande et al, 2013), three articles were cohort studies (retrospective cohort dan population-based retrospective cohort) (Gu et al, 2016;Jones et al, 2020;Misra-Hebert et al, 2021) and three articles were qualitative studies (Campos et al, 2014;Kari et al, 2022;Silverman et al, 2018). In the RCT targeting postpartum mothers, the intervention group received health care through home visits by midwives, while the control group was only given services at health facilities (Mirmolaei et al, 2014).…”

“…Various countries implement varying home visits' scope of services and providers. The scope of services in this review is categorized based on the life cycle, specifically maternal and child health (Flores-Quispe et al, 2022;Mirmolaei et al, 2014;Nsibande et al, 2013), productive age and the elderly (Gu et al, 2016;Jones et al, 2020;Kari et al, 2022;Luger et al, 2016;Misra-Hebert et al, 2021;Silverman et al, 2018), and life-cycle approach (Campos et al, 2014). The home visits are mostly conducted by community health workers and nurses, followed by doctors, midwives, and multidisciplinary teams.…”

“…In a study conducted in South Africa, home visits were carried out by CHW to perform ante and postnatal services, including making referrals as needed (Nsibande et al, 2013). In Brazil, CHW conducted home visits within one week after childbirth to monitor the health of both mother and baby (Flores-Quispe et al, 2022). Home visits by trained midwives in Iran were carried out at 10-15 days and 42-60 days postpartum for both the mother and the baby (Mirmolaei et al, 2014).…”

“…Infants born to mothers who received home visits one week postpartum were 96% more likely to receive quality service compare to those who did not. The services provided during home visits measuring the baby's weight and length, heel prick test, umbilical cord examination, breastfeeding observation, and counselling on the baby' safe sleeping position (Flores-Quispe et al, 2022). The home visit in RCT in Austria where lay health workers together with the elderly in the first group performed exercises and discussed nutrition-related aspects and the second group provided social support can help to address nutrition and frailty syndrome status.…”

“…Home visits are carried out for the target group which are mother and child, productive ages, and elderly to provide comprehensive health services according to life-cycle or specific to certain diseases. This review showed home visits for mother and child was mainly carried out for post-partum services (Flores-Quispe et al, 2022;Mirmolaei et al, 2014). Only one study included home visits for both antenatal and postnatal care (Nsibande et al, 2013).…”