Planejamento estratégico e redução da mortalidade infantil : a experiência de Caxias do Sul (RS)

Abstract

A seguir, foi elaborado plano de ações para cada nó crítico, definidas as operações a serem desenvolvidas, os recursos necessários, bem como responsabilidades, apoio e prazos para sua concretização. O plano foi formatado para cada área de atuação, quer sejam a assistência pré-natal, a atenção ao parto, o acompanhamento da criança e a assistência ao adolescente. O trabalho foi concluído com a análise das motivações dos atores sociais envolvidos, na busca de viabilizar as ações planejadas e possibilitar a execução do plano.

Infant mortality, an indicator of the population quality of life, has not changed very much in the city of Caxias do Sul in the last years. In spite of the increased availability of resources: health centers, health care services, pediatric and obstetric hospital beds, neonatal intensive care units and pharmaceutical assistance; neonatal mortality remains relatively stable. In 2003, neonatal mortality increased from 13.06/1,000 in 2002 to 15.46/1,000. More than 70% of deaths were considered to be from avoidable causes. This work proposes a plan to neonatal mortality by risk factors management and intervention control of avoidable causes of deaths. The “Strategic Situation Planning” methodology, proposed by Matus, was used to identify the determinants and consequences of infant mortality; and to identify the critical related nodes in the health service process. Based in this analysis an action plan was developed for each critical node including: keyservices, resources requirements, responsibilities, support and an implementation schedule. Each part of the plan: prenatal assistance, perinatal services and delivery, child and adolescent health services was developed principally by the sector responsible for those services. The article concludes with an analysis stake-holders motivation to implement and operationalize the plan.