PRENACEL: Development and evaluation of a communication strategy to improve quality of prenatal care

Abstract

The low quality of women's health care during ante-natal program, birth delivery and postpartum is a factor which contributes to the maternal e perinatal mortality in Brasil. To establish a communication channel between the health service and its users can stimulate the adherence to the ante-natal program, increase the demand for preventive and therapeutic actions, provide information, dissipate doubts, receive complaints and have positive impact in women's mental health. The use of mobile phone technology is considered promissing and can improve the quality of the ante-natal care follow up. This study aims to determine if a program of health education supporting women and partners ( adapted to SUS and to the plataform of mobile phone) is a useful complement to the standard follow up during pregnancy, birth and puerperium period. The study is designed as a cluster randomized trial to be carried out among clients of 20 Primary Health Care Clinics in Ribeirão Preto. The clinics will be splited in two groups: one which will receive intervention, case, (PRENACEL + standard ante natal care program) and the other control (standard ante natal care program). Pregnant women and partners will receive regularly short messages with information about the pregnancy, birth delivery , postpartum and ante-natal care The study population will be formed by 581 pregnant women and 146 partners. The sum of missed oportunities will be used as the main measure of outcome. Satisfaction level, mental health as well as the use of contraceptives will be assessed in a household interview. Data will be collected during 33 weeks in four maternity hospitals just after birth. The cases of Severe Maternal Morbidity will be compared with cases and controls. Analysis for Treatment Intention will be performed for PRENACEL cases and control and for the cases of Maternal Morbidity the search of associated factors. We are requesting FAPESP support to continue the follow-up postpartum at 8th week and 6 months postpartum to evaluate the delayed effect of sending messages on reproductive and mental variables of these women. (AU)