Banca de QUALIFICAÇÃO: MARIA JULIANA DA SILVA ROCHA ARAÚJO

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : MARIA JULIANA DA SILVA ROCHA ARAÚJO
DATE: 31/10/2025
TIME: 16:00
LOCAL: webconferência
TITLE:

Access, Shared Care and Support Network: A Qualitative Study on the Experience of High-Risk Pregnant Women in the Unified Health System

KEY WORDS:

High-Risk Prenatal Care; Inter-federative Co-management; Paternity; Social Inequity 

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Saúde Pública
SUMMARY:

Maternal Mortality (MM) is a persistent indicator of social inequity and systemic failures in public health. High-Risk Prenatal Care (HRPC) is a crucial strategy for its reduction, requiring coordinated, continuous, and specialized assistance. This study aimed to analyze the effectiveness of care co-production in the Brazilian Unified Health System (SUS), focusing on the discontinuity of multiprofessional monitoring, logistical barriers, financial burden, and the impact of partner and support network involvement in the high-risk pregnancy experience. The research adopted a qualitative, descriptive, and exploratory approach, conducted in a maternity hospital in the interior of Rio Grande do Norte. The sampling was by convenience, with the final analysis comprising 18 participants. Data collection occurred between October and November 2024 through recorded semi-structured interviews. Data analysis utilized Bardin's Content Analysis (2011) and the Atlas.ti software. Results revealed that although the structural model of shared care between Primary Health Care (PHC) and specialized services is established and seeks integrality, its efficacy is undermined by operational failures in network management. Institutional disarticulation leads to critical scheduling delays (return extended beyond one month), transforming clinical risk into managerial risk, and causing ineffective access to specialists. More critically, co-management failure transfers logistical and financial burdens to the pregnant woman, who must pay for vital medications (e.g., blood pressure drugs) and essential supplies, and rely on uncertain municipal transport. This scenario penalizes low-income pregnant women, reinforcing social inequity. Concurrently with systemic failures, partner involvement was limited by socio-cultural and structural barriers, such as demanding work routines, lack of interest, and conflicts. This absence, often restricted to ultrasound exams, highlights a discrepancy between the woman's expectation and the reality, generating frustration and insecurity. This socio-cultural exclusion limits the man's role to financial provision. The fragility of conjugal support intensifies maternal stress and anxiety, potentially aggravating the high-risk condition. It is concluded that the ideal HRPC structure is doubly compromised by administrative inefficiency (systemic failure) and limited partner participation (socio-cultural barrier), collectively transforming operational obstacles into clinical risk and socioeconomic vulnerability. There is an urgent need for the administrative improvement of the network so that inter-federative co-management translates into efficiency and the implementation of intersectoral policies (health, work, and education) to ensure equity, integrality, and the reduction of preventable maternal morbidity and mortality.

COMMITTEE MEMBERS:
Presidente - 1893928 - OSVALDO DE GOES BAY JUNIOR
Interna - 2507055 - CRISTIANE DA SILVA RAMOS MARINHO
Interno - 1152605 - FRANCISCO CLEITON VIEIRA SILVA DO RÊGO