Desenvolvimento de tecnologias sociais na área da saúde da mulher : intervenções em nível comunitário com gestantes

Ensuring full care to reproductive health in a timely and adequate manner through the promotion of health, protection, assistance and recovery of health, contributes significantly to women's well -being and the reduction of maternal and child mortality. Among the many social determinants of maternal and child mortality, education, income and social participation stand out. Restricting access to these social goods risks the maternal wellbeing and increases the risk of maternal morbidity and child mortality, especially in vulnerable populations, which represents a major public health problem. In regions deprived of socio-economic conditions, the technologies based on a biomedical health model that is centered on disease prevention and individual responsibility are not enough to produce the desired impact on improving maternal and child health indicators. Thus, it becomes important to develop social technological interventions having as a goal the perspective of health promotion at the community level towards pregnant women, and aiming at improving maternal health. So we held an emancipatory action research with the overall objective to develop, implement and evaluate a specific social technology in the area of maternal health, with resident women at the Setor Habitacional Sol Nascente, a place of high social vulnerability, situated in Ceilândia, one of the administrative regions in the Federal District. At first, three groups of 32 pregnant women were formed during the educational workshop sessions for the group dynamics. They addressed women and children’s health themes. During the second stage of the investigation, four months after the first, two focus groups were developed with a total of 15 women in their postpartum period, and one of the groups was made up of women who had participated in the previous step. Record data from the B GES Primary Health Care System and the pregnant card were used for the construction of the socio-demographic profile of the women studied. The participants were nulliparous women, primiparous and multiparous, aged between 14 and 41 years. A comparative evaluation of the focus groups was made to identify the contributions of the construction of shared knowledge, using reports of pregnant women and researchers on issues related to women's health during pregnancy and puerperal period in the induction of transformative practices in promoting the wellbeing of women and prevention of maternal and child mortality. The reports of the groups were subjected to content analysis. Some of the workshop results were: the lack of knowledge of pregnant woman's rights by some women; professionals with different communication profiles, some who encourage participation and others who have disabilities concerning communication skills; verbal abuse from health professionals. The analysis of the two focus groups identified the partial fulfillment of the pregnant woman's rights in all of the line steps of maternal and child care, especially regarding the right of access to information and guidance. More women who participated in the educational workshops have reported situations featuring empowerment. It is necessary further research to evaluate the empowerment throughout the evolution of pregnancy and puerperal cycle and the factors that favor the development of social technologies of intervention in maternal health.