SISPRENATAL as a tool for evaluating quality of prenatal care

To evaluate coverage by the Prenatal and Birth Humanization Program, according to its minimal requirements and process indicators, by comparing information from prenatal booklets to SISPRENATAL (System to Accompany the Prenatal and Birth Humanization Program).

A cross-sectional study was carried out with prenatal data from 1,489 women in the postpartum period after birth in the Brazilian Unified Health System, between November 2008 to October 2009 in São Carlos municipality, Southeastern Brazil. Data were collected from the prenatal booklet and afterwards from the SISPRENATAL. Information from both sources was compared using the McNemar Χ² test for related samples.

Prenatal coverage in relation to the number of live births was 97.1% according to the prenatal booklet and 92.8% according to SISPRENATAL. There were statistical significant differences between both sources of information for all the minimum requirements of the Prenatal and Birth Humanization Program, and also the process indicators. Except for the first prenatal visit, the prenatal booklet always had greater frequencies than SISPRENATAL. The proportion of women with six or more prenatal visits and all basic exams was 72.5%, according to the prenatal booklet and 39.4% by the official system. These differences remained for the five health regions in the municipality.

SISPRENATAL was not a reliable source for evaluating the available information on care during pregnancy. There was high adherence to the Prenatal and Birth Humanization Program, but documentation of information was insufficient for all the minimum requirements and process indicators. Ten years after the start of the program, municipalities should provide adequate quality of care and build health professional capacity for proper documentation of health information.