The maternity ward of a teaching hospital: reconfiguration of maternal-child nursing care / Maternidad de un hospital-escuela: reconfiguración de la asistencia de enfermería materno-infantil / Maternidade de um hospital-escola: reconfiguração da assistência de enfermagem materno infantil

ABSTRACT Objective: to analyze the strategies used by nurses and nurse professors for a better position in the maternity ward of the teaching hospital of the Universidade Federal do Espírito Santo. Method: this is a social-historical study with a qualitative approach. The primary sources were written documents, such as official letters, memos, ordinances, standards and routines of the hospital; photographic material; and oral testimonies from seven participants. The interviews were performed using a semi-structured questionnaire, with questions regarding the adaptation from a sanatorium to a teaching hospital, the challenges faced, and the strategies adopted by the nursing department. Results: the results allowed us to understand the close link between the maternity ward and the nursing course of the Universidade Federal do Espírito Santo, which created a differentiated nursing care that integrated training and care with a broader and humanized look. Final considerations: the actions of the nurses were recognized and gave them professional visibility, influencing a new form of care in the maternity ward.

RESUMEN Objetivo: analizar las estrategias usadas por las enfermeras asistenciales y enfermeras docentes por una mejor posición en la maternidad del hospital-escuela de la Universidad Federal de Espírito Santo. Método: estudio de naturaleza histórico-social con abordaje cualitativo. Las fuentes primarias se constituyeron de documentos escritos, como los oficios, los memorandos, los decretos, las normas y las rutinas hospitalarias; el material fotográfico; y las declaraciones orales de siete participantes. La encuesta fue orientada por la ruta semiestructurada con cuestiones sobre la adaptación del sanatorio para hospital-escuela, los retos enfrentados y las estrategias adoptadas por la enfermería. Resultados: permitieron entender la estrecha vinculación de la maternidad con el curso de enfermería de la Universidad Federal de Espírito Santo, el que determinaba una asistencia de enfermería diferenciada, la cual integraba enseñanza y asistencia con una mirada más amplia y humanizada. Consideraciones finales: las acciones de las enfermeras fueron reconocidas y generaron visibilidad profesional, influenciando una nueva manera de cuidar en la maternidad.

RESUMO Objetivo: analisar as estratégias usadas pelas enfermeiras assistenciais e enfermeiras docentes por uma melhor posição na maternidade do hospital-escola da Universidade Federal do Espírito Santo. Método: estudo de natureza histórico-social com abordagem qualitativa. As fontes primárias constituíram-se de documentos escritos, como ofícios, memorandos, portarias, normas e rotinas hospitalares; material fotográfico; e depoimentos orais de sete participantes. A entrevista foi orientada por roteiro semiestruturado com questões sobre a adaptação do sanatório para hospital-escola, os desafios enfrentados e as estratégias adotadas pela enfermagem. Resultados: permitiram entender a estreita vinculação da maternidade com o curso de enfermagem da Universidade Federal do Espírito Santo, o que determinava uma assistência de enfermagem diferenciada, a qual integrava ensino e assistência com um olhar mais amplo e humanizado. Considerações finais: as ações das enfermeiras foram reconhecidas e geraram visibilidade profissional, influenciando uma nova forma de cuidar na maternidade.

Neoliberalismo en salud: La tortura de trabajadoras y trabajadores del Instituto Materno Infantil de Bogotá / Neoliberalism in health: the torture of the health care workers of the Bogota s Instituto Materno Infantil (child and maternity hospital)

Objetivos Relacionar históricamente las transformaciones más significativas del Instituto Materno Infantil (IMI) en su proceso de crisis, cierre y liquidación con las experiencias de sus trabajadores/as. Encontrar elementos vivenciales y teóricos que interconecten el proceso de privatización de la salud con las experiencias de resistencia y dolor/sufrimiento de trabajadores/as. Métodos Etnografía inscrita en corrientes críticas y apoyada en trabajo de campo constante y colectivo, investigación histórica (fuentes primarias y secundarias) y entrevistas semiestructuradas con cinco mujeres que trabajaron por más de quince años en el IMI. Resultados Una línea del tiempo con cuatro periodos principales: Los años de gloria (hasta 1990), Llega el neoliberalismo (1990-2000), La crisis y las resistencias (2001-2005) y Liquidación (2006-). La narrativa de las mujeres entrevistadas devela múltiples agresiones que se intensificaron desde el 2006 generando dolor/ sufrimiento, relatos que ilustran violaciones a sus derechos humanos y laborales. Discusión Proponemos analizar las conexiones entre los diferentes tipos de violencia y el dolor/sufrimiento bajo la categoría tortura, entendida como acciones violentas que causan dolor físico-emocional, las cuales son ejecutadas por actores de poder sobre otros que desafían alterarlo. Enfatizamos en las burocracias, el confinamiento, los agentes torturadores y los resquebrajamientos a la unidad mente/cuerpo para argumentar que esta relación neoliberalismo y tortura pretende eliminar los últimos trabajadores/as de la salud del país con garantías laborales para avanzar en la acumulación de capital que genera la creciente sobreexplotación del trabajo y la mercantilización de la salud.

Objectives To link, from a historical point of view, the most significant transformations of the Instituto Materno Infantil (IMI) [the oldest child and maternity hospital of the country] during its process of crisis, closure and liquidation with the experiences of the hospital workers. To find experience-based and theoretical elements that can interconnect the process of health care privatization of the country with the workers' experiences of resistance and pain/suffering. Methods Critically-oriented ethnography based on continuous collective field work, historical research (primary and secondary sources) and semi-structured interviews with 5 women who worked at the IMI for more than 15 years.Results: A time line of 4 main periods: Los años de gloria [The golden years] (up to 1990); Llega el neoliberalismo [Neoliberalism arrives] (1990-2000); La crisis y las resistencias [Crisis and resistances] (2001-2005); and Liquidación [Liquidation (2006-20??)]. The narratives of the interviewed women unveil multiple aggressions that have intensified since 2006, have caused pain and suffering and are examples of violations of human and labour rights. Discussion We suggest to analyze the links between the different kinds of violence and pain and suffering as torture. This category is defined as the set of violent actions that cause physical and emotional pain, which are performed by actors in positions of power over other people who challenge that power and are part of modern States' ideological principles around a defined moral social order. For the IMI workers' case, the ideological principle that is being challenged is health care neoliberalism. From the analyses of bureaucracy, confinement, torturing agents, and the breaking-off of the body-mind unit we conclude that this relationship between neoliberalism and torture aims to eliminate the last health care workers of the country who had job stability and full-benefits through public labour contracts. Their elimination furthers the accumulation of capital generated by increasing over-exploitation of labour and commodification of health care.

Patient Satisfaction on Maternal and Child Health Services.

Introduction : Services are being provided by health functionaries to the community with the objective of fulfilling their satisfaction but sometimes this do not working for the target population. Objective : To assess the satisfaction of patients receiving some MCH services in rural areas of Wardha district. Material and Methods : It was a longitudinal study from June 2007 to September 2009, comprising of 205 participants (i.e. registered pregnant women of < 16 weeks of gestation), they were given 8 visits by investigator. Outcome variables of the study were socio - demographic profile, selective obstetrical history and some maternal and child health services. Data was collected based on preformed questionnaires, a modification of PHC MAP module guidelines for assessing the quality of service-module 6-user’s guide. The response (quality) of each service during entire visit was quantified as acceptable (ACQ), average and worst (WQ). Results : Patient satisfaction or ACQ of ANC services was 51.49% and PNC services was only 22.64 %, only 18.53% participants received counselling for hospital delivery in all the five visits. WQ observed for history of consanguineous marriage 50.24%, height measurement 47.31% and breast examination 91.21% during ANC. Among all the services of PNC, counselling for immunization of baby was highest but 40.97%. It was observed WQ for weight recording 42.43% and counselling for birth registration 76.09 % during PNC. Conclusion : An overview of patient satisfaction receiving some MCH services were shown in this study and needs to be strengthened from care providers side.

Melhoria na qualidade da saúde materno-infantil no Município de Manicoré - AM, no período de 2001 to 2004 / Improvement of quality for child and maternal health in the city of Manicoré - AM, from 2001 to 2004

Este artigo é resultado de uma pesquisa sobre um passado recente na vida dos cidadãos Manicorenses e a realidade vivida hoje pela população. Depois da ativação do Hospital Maternidade Pública Manicorense local, a qualidade de vida dos cidadãos mudou quase que repentinamente. Foi relevante a atuação dos órgãos públicos municipais nas pessoas do Secretário Municipal de Saúde e do Prefeito da cidade. Houve avanço na qualidade de vida do cidadão, servindo como referência e bom exemplo para outras cidades da região. O conteúdo do artigo revela como a atuação do Estado em nível municipal (Manicoré) foi importante para a implantação de políticas públicas com participação das comunidades locais. Estas conheciam quais suas necessidades e o Estado foi apenas intermediário. Foram implantados projetos para treinamento, tendo-se observado incremento na qualidade de vida das comunidades ribeirinhas de Manicoré

El parto humanizado y los derechos de la mujer embarazada / Humanized delivery and pregnant women rights

Se indican los errores y los aspectos negativos, que cometen los medicos y el personal de salud en la atencion de la mujer embarazada, durante el parto y el puerperio. Se señalan hechos puntuales y concretos de esos errores y se realiza una critica constructiva a esas actitudes en base a una abundante literatura cientifica internacional. Tambien se observa el trato frio, deshumanizado e impersoanl que tienen algunos medicos y trabajadores de salud con la mujer embarazada durante el parto. Todo ello con el fin de abolir la rutina, la frialdad y el trato deshumanizado en los centros de maternidad en clinicas y hospitales y de esa manera estimular al equipo de salud a realizar la atencion de la mujer en mejor forma y traer a este mundo cada vez conflictivo, seres mas sanos y sin defectos

The nutritional situation in metropolitan Kuala Lumpur, with focus on squatters.

Kuala Lumpur is the capital city of Malaysia with an estimated population of 1.55 million. Approximately 12% of the population live in squatter settlements occupying about 7% of the city total area. The squatter settlements generally are provided with basic amenities such as piped water, toilet facilities and electricity. Health indicators for the overall population of Kuala Lumpur are better off than for the rest of the country; however, intra-city differentials prevail along ethnic and socio-economic lines. Malays and Indians have higher rates for stillbirths, and neonatal, infant and toddler mortality than the Chinese. The wide disparity in the socio-economic status between the advantaged and the poor groups in the city is reflected in the dietary practices and nutritional status of young children from these communities. The percentage of preschool children from urban poor households with inadequate intakes of calories and nutrients is two to three times higher than those from the advantaged group. Compared to rural infants, a lower percentage of urban infants are breastfed. A lower percentage of Malays from the urban advantaged group breastfed, compared with the urban poor group. The reversed trend is found for the Chinese community. Growth attainment of young children from the urban poor is worse than the urban advantaged, though better than the rural poor. Health and nutritional practices implications related to both undernutrition and overnutrition are discussed, to illustrate the twin challenges of malnutrition in the city.