Avaliação da qualidade da atenção materno infantil na perspectiva das usuárias na Atenção Básica do Rio Grande do Norte

Abstract

The study aims to analyze the quality of Maternal and Child Health within the scope of Primary Care in Rio Grande do Norte in the three cycles of the PMAQ-AB from the perspective of users. This is an evaluative, cross-sectional, retrospective study using secondary data from the 1º, 2º and 3º cycle of the PMAQ-AB. The sample consisted of 7,787 users, respectively, 1,085, 715 and 866 Basic Health Units participating in the external evaluation of the Program, in the 3 cycles. The dependent variables for evaluation in the three cycles were “satisfaction with care”, “material conditions”, “access to health services”, “inputs” and “drugs”. For the last three variables, scores were created using the interdependence technique (Exploratory Factor Analysis of the Principal Component Analysis (PCA) type and Item Response Theory (IRT) type, obtained to reduce the number of variables in each dimension and subdimension. Pearson's chi-square test and Kruskal-Wallis' H test were used to compare quality scores, means of satisfaction with care and availability of materials, among the three PMAQ cycles. In the organizational dimension, when analyzing the quality of care, a significant difference (p>0.001) between the 3 cycles was identified in the women's health subdimension, totaling 51% in the last cycle. Regarding satisfaction with care, 90.2% recommended the Basic Health Unit to a friend or family member (p>0.001) and only 13.2% (p>0.001) of the users would change their team or Basic Health Unit if had the option. The structural dimension showed improvement in the three sub-dimensions 44% (p>0.001), drugs 52.4% (p>0.001) and material 93.6% (p>0.001). There is an improvement in Primary Care from the perspective of users in Rio Grande do Norte, especially in women's health. It is also evident the importance of investing in quality improvement programs to strengthen Primary Care.