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Analysis, monitoring and improvement of the pregnant woman's oral health care network


The emergence of chronic diseases demanded from the Brazilian health system continuous and integrated care for its users, differing from fragmented care, which was mainly focused on acute illnesses. The Health Care Networks (RAS) thus emerge with the aim of promoting the integration of the care system, and the rationalization of resources. The Maternal and Child Health Care Network in the SUS, including oral health, is still a challenge for managers, due to the existence of difficulties, ranging from the access to basic care, to the referral to the specialized service. Studies on the evaluation of health care networks are essential, as they can contribute to the advancement of the implementation process of the Unified Health System-SUS. This research aims to study prenatal care for high-risk pregnant women, focusing on breastfeeding and oral health in medium-complexity health services, a reference for 28municipalities in the state of São Paulo. This is a cross-sectional, quantitative and qualitative study, to be carried out in three phases: Phase I - Exploratory; Phase II-Intervention and Phase III - Evaluation. Data will be collected in the health services of28 municipalities in the state of São Paulo and in the Specialty Medical Clinic (AME), on: socio-demographic profile of pregnant women; demand organization in the regional health care network; referral and counter-referral system for services; oral health status of high-risk pregnant women and implementation of protocols for dental care for high-risk pregnant women. It will also be possible to obtain information about the referral and counter-referral system, criteria and forms of referral to guarantee comprehensive care. All the tools employed and the data obtained will be able to help direct the strategic planning of actions in health services, both in Primary and Specialized Care. Quantitative data will be submitted to appropriate statistical analysis, at a significance level of 5%. For the treatment of data from document analysis and direct observation, the thematic technique will be used to answer the research question. Qualitative data will be analyzed using the content analysis technique, with the aim of objectively and systematically identifying the manifest content, subjectively, in the participants speeches on the guiding question addressed. The categorization technique will be used, according to the existing theme in the speeches, classifying it by keywords that best describe it. The project was submitted to the ethics committee of FOA-Unesp and aspects related to conducting research with human beings will be respected. (AU)

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