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

• Published in: BMJ open 2022-04, Vol.12 (4), p.e049342
• Main Authors: Flores-Quispe, Maria del Pilar, Duro, Suele Manjourany Silva, Blumenberg, Cauane, Facchini, Luiz, Zibel, Alexsandro Behrens, Tomasi, Elaine
• Format: Article
• Language: English
• Subjects: Adult; Age; Brazil; Breastfeeding & lactation; Child, Preschool; Childrens health; community child health; Counseling; Cross-Sectional Studies; Data collection; Delivery of Health Care; Epidemiology; Female; Higher education; Humans; Infant; Infant, Newborn; Interviews; Logistics; Middle Aged; Mothers; Multilevel Analysis; Newborn babies; Primary care; Primary Health Care; Public health; quality in health care; Umbilical cord
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-049342

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.