Process and outcome of prenatal care according to the primary care models: a cohort study

Area of Science:

• Public Health
• Maternal and Child Health
• Primary Care Research

Background:

• Prenatal care is crucial for maternal and infant well-being.
• Comparing traditional care with the Family Health Strategy (FHS) in primary care is essential for optimizing services.
• The Social Determinants of Health framework provides insight into health disparities.

Purpose of the Study:

• To evaluate process and outcome indicators of prenatal care.
• To compare traditional prenatal care models with the Family Health Strategy (FHS) within primary care settings.

Main Methods:

• A cohort study involving 273 mothers/babies, followed from the neonatal period for one year.
• Utilized Donabedian's evaluation framework and analyzed data through the lens of Social Determinants of Health.
• Employed relative risk for process evaluation and Cox Multiple Regression for outcome evaluation.

Main Results:

• Family Health Units (FHUs) showed a higher risk of low prenatal quality scores, despite more postpartum consultations and health education.
• Lower income was associated with a higher risk of low prenatal quality scores in FHUs.
• No significant differences in outcome indicators (birth conditions, first-year health) were observed between the care models.

Conclusions:

• Enhanced prenatal care quality within the FHS may mitigate negative socioeconomic impacts on health outcomes.
• Despite process variations, both traditional and FHS models achieved similar outcomes, suggesting resilience in the FHS.
• Further research is needed to fully understand the interplay between care quality, socioeconomic factors, and health outcomes in primary care.