A Tendência dos Serviços prestados pelos Bancos de Leite Humano entre 2010 e 2019 no Brasil

De acordo com o artigo Carrijo et. al (2022) rotineiramente, as nutrizes recorrem aos profissionais do Banco de Leite Humano para orientação sobre o manejo correto da amamentação (AM), para aprender ou corrigir a técnica, evitar complicações e possibilitar o estabelecimento e manutenção da lactação. Aconselhamento individual ou apoio em grupo, apoio imediato ao aleitamento após o parto e manejo da lactação foram intervenções que aumentaram o aleitamento materno exclusivo (AME) em 49% e o AM em 66%.

Associations between postpartum depression and assistance with household tasks and childcare during the COVID-19 pandemic: evidence from American mothers.

BACKGROUND: The early postpartum period is recognized cross-culturally as being important for recovery, with new parents receiving increased levels of community support. However, COVID-19-related lockdown measures may have disrupted these support systems, with possible implications for mental health. Here, we use a cross-sectional analysis among individuals who gave birth at different stages of the pandemic to test (i) if instrumental support access in the form of help with household tasks, newborn care, and care for older children has varied temporally across the pandemic, and (ii) whether access to these forms of instrumental support is associated with lower postpartum depression scores. METHODS: This study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant persons in the United States. Participants completed postnatal surveys between April 30 - November 18, 2020 (n = 971). Logistic regression analysis tested whether birth timing during the pandemic was associated with odds of reported sustained instrumental support. Linear regression analyses assessed whether instrumental support was associated with lower depression scores as measured via the Edinburgh Postnatal Depression survey. RESULTS: Participants who gave birth later in the pandemic were more likely to report that the pandemic had not affected the help they received with household work and newborn care (p < 0.001), while access to childcare for older children appeared to vary non-linearly throughout the pandemic. Additionally, respondents who reported that the pandemic had not impacted their childcare access or help received around the house displayed significantly lower depression scores compared to participants who reported pandemic-related disruptions to these support types (p < 0.05). CONCLUSIONS: The maintenance of postpartum instrumental support during the pandemic appears to be associated with better maternal mental health. Healthcare providers should therefore consider disrupted support systems as a risk factor for postpartum depression and ask patients how the pandemic has affected support access. Policymakers seeking to improve parental wellbeing should design strategies that reduce disease transmission, while facilitating safe interactions within immediate social networks (e.g., through investment in COVID-19 testing and contact tracing). Cumulatively, postpartum instrumental support represents a potential tool to protect against depression, both during and after the COVID-19 pandemic.

Women's experiences of maternal and newborn health care services and support systems in Buikwe District, Uganda: A qualitative study.

BACKGROUND: Uganda continues to have a high neonatal mortality rate, with 20 deaths per 1000 live births reported in 2018. A measure to reverse this trend is to fully implement the Uganda Clinical Guidelines on care for mothers and newborns during pregnancy, delivery and the postnatal period. This study aimed to describe women's experiences of maternal and newborn health care services and support systems, focusing on antenatal care, delivery and the postnatal period. METHODS: We used triangulation of qualitative methods including participant observations, semi-structured interviews with key informants and focus group discussions with mothers. Audio-recorded data were transcribed word by word in the local language and translated into English. All collected data material were stored using two-level password protection or stored in a locked cabinet. Malterud's Systematic text condensation was used for analysis, and NVivo software was used to structure the data. FINDINGS: Antenatal care was valued by mothers although not always accessible due to transport cost and distance. Mothers relied on professional health workers and traditional birth attendants for basic maternal services but expressed general discontentment with spousal support in maternal issues. Financial dependency, gender disparities, and lack of autonomy in decision making on maternal issues, prohibited women from receiving optimal help and support. Postnatal follow-ups were found unsatisfactory, with no scheduled follow-ups from professional health workers during the first six weeks. CONCLUSIONS: Further focus on gender equity, involving women's right to own decision making in maternity issues, higher recognition of male involvement in maternity care and improved postnatal follow-ups are suggestions to policy makers for improved maternal care and newborn health in Buikwe District, Uganda.

Level of inequality and the role of governance indicators in the coverage of reproductive maternal and child healthcare services: Findings from India.

BACKGROUND: Diligent monitoring of inequalities in the coverage of essential reproductive, maternal, new-born and child health related (RMNCH) services becomes imperative to smoothen the journey towards Sustainable Development Goals (SDGs). In this study, we aim to measure the magnitude of inequalities in the coverage of RMNCH services. We also made an attempt to divulge the relationship between the various themes of governance and RMNCH indices. METHODS: We used National Family Health Survey dataset (2015-16) and Public Affairs Index (PAI), 2016 for the analysis. Two summative indices, namely Composite Coverage Index (CCI) and Co-Coverage (Co-Cov) indicator were constructed to measure the RMNCH coverage. Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were employed to measure inequality in the distribution of coverage of RMNCH. In addition, we have used Spearman's rank correlation matrix to glean the association between governance indicator and coverage indices. RESULTS & CONCLUSIONS: Our study indicates an erratic distribution in the coverage of CCI and Co-Cov across wealth quintiles and state groups. We found that the distribution of RII values for Punjab, Tamil Nadu, and West Bengal hovered around 1. Whereas, RII values for Haryana was 2.01 indicating maximum inequality across wealth quintiles. Furthermore, the essential interventions like adequate antenatal care services (ANC4) and skilled birth attendants (SBA) were the most inequitable interventions, while tetanus toxoid and Bacilli Calmette- Guerin (BCG) were least inequitable. The Spearman's rank correlation matrix demonstrated a strong and positive correlation between governance indicators and coverage indices.

Setting the Agenda for Reproductive and Maternal Health in the Era of COVID-19: Lessons from a Cruel and Radical Teacher.

BACKGROUND: COVID-19 exposes major gaps in the MCH safety net and illuminates the disproportionate consequences borne by people living in low resource communities where systemic racism, community disinvestment, and social marginalization creates a perfect storm of vulnerability. METHODS: We draw eight lessons from the first 8 months of the pandemic, describing how COVID-19 has intensified pre-existing gaps in the MCH support network and created new problems. For each lesson identified, we present supporting evidence and a call for specific actions that can be taken by MCH practitioners, researchers and advocates. RESULTS: LESSON #1: COVID-19 hits communities of color hardest, exposing and exacerbating health inequities caused by systemic racism. LESSON #2: Women experience the most devastating social, economic and mental health tolls during COVID-19. LESSON #3: Virulent pathogens find and exacerbate cracks in our public health and health care systems. LESSON #4: COVID-19 has become a pretext to limit access to sexual and reproductive health care. LESSON #5: COVID-19 has exposed and deepened fault lines in maternity care: over-medicalization, discrimination, lack of workforce diversity, underutilization of collaborative team approaches, and lack of post-delivery follow-up. LESSON #6: The pandemic adds impetus to much-needed Medicaid policy reforms that can have a lasting positive effect on maternal health. LESSON #7: Social and health policy changes, heretofore deemed infeasible, ARE possible under pandemic threat. LESSON #8: Finally, an overarching COVID-19 lesson: We are all inextricably connected. CONCLUSION: COVID-19 is a loud wake up call for renewed action by MCH epidemiologists, policy-makers, and advocates.

Trends in and determinants of visiting private health facilities for maternal and child health care in Nepal: comparison of three Nepal demographic health surveys, 2006, 2011, and 2016.

BACKGROUND: Maternal and child health care services are available in both public and private facilities in Nepal. Studies have not yet looked at trends in maternal and child health service use over time in Nepal. This paper assesses trends in and determinants of visiting private health facilities for maternal and child health needs using nationally representative data from the last three successive Nepal Demographic Health Surveys (NDHS). METHODS: Data from the NDHS conducted in 2006, 2011, and 2016 were used. Maternal and child health-seeking was established using data on place of antenatal care (ANC), place of delivery, and place of treatment for child diarrhoea and fever/cough. Logistic regression models were fitted to identify trends in and determinants of health-seeking at private facilities. RESULTS: The results indicate an increase in the use of private facilities for maternal and child health care over time. Across the three survey waves, women from the highest wealth quintile had the highest odds of accessing ANC services at private health facilities (AOR = 3.0, 95% CI = 1.53, 5.91 in 2006; AOR = 5.6, 95% CI = 3.51, 8.81 in 2011; AOR = 6.0, 95% CI = 3.78, 9.52 in 2016). Women from the highest wealth quintile (AOR = 3.3, 95% CI = 1.54, 7.09 in 2006; AOR = 7.3, 95% CI = 3.91, 13.54 in 2011; AOR = 8.3, 95% CI = 3.97, 17.42 in 2016) and women with more years of schooling (AOR = 1.2, 95% CI = 1.17, 1.27 in 2006; AOR = 1.1, 95% CI = 1.04, 1.14 in 2011; AOR = 1.1, 95% CI = 1.07, 1.16 in 2016) were more likely to deliver in private health facilities. Likewise, children belonging to the highest wealth quintile (AOR = 8.0, 95% CI = 2.43, 26.54 in 2006; AOR = 6.4, 95% CI = 1.59, 25.85 in 2016) were more likely to receive diarrhoea treatment in private health facilities. CONCLUSIONS: Women are increasingly visiting private health facilities for maternal and child health care in Nepal. Household wealth quintile and more years of schooling were the major determinants for selecting private health facilities for these services. These trends indicate the importance of collaboration between private and public health facilities in Nepal to foster a public private partnership approach in the Nepalese health care sector.

Comportamiento de algunos indicadores del Programa Materno Infantil en Campechuela durante los años 1980-2018 / Behavior of some indicators of the Maternal and Child Program in Campechuela during the years 1980-2018

Introducción: el Programa Materno Infantil es un programa muy sensible en el sector de la salud ya que declara la atención integral tanto a la embarazada, a la madre, al niño y al adolescente. Las tasas de mortalidad fetal, en menores de un año y el bajo peso al nacer son indicadores que reflejan las condiciones de vida de la mujer; la morbilidad subyacente y la calidad de vida de una sociedad. Objetivo: determinar el comportamiento de estos dos indicadores en el municipio de Campechuela durante los años 1980 a 2018, período de 39 años. Métodos: se realizó un estudio observacional descriptivo, retrospectivo. El universo comprendió todos los nacimientos en Campechuela en los años de estudio, las muertes en menores de 1 año, las muertes fetales y el bajo peso al nacer. Se representaron los resultados expresados en frecuencias absolutas, frecuencias relativas y tasas. Mediante el empleo de las técnicas de la estadística descriptiva. Resultados: la natalidad ha disminuido a lo largo del período en estudio con variaciones en el tiempo, la tasa de mortalidad infantil ha tenido una disminución considerable, no siendo así, el bajo peso que han tenido fluctuaciones, y las defunciones fetales se ha comportado de forma desfavorable, los resultados permiten valorar que hay que intensificar aún más el control y seguimiento a este grupo priorizado, e incrementar las pesquisas de los factores de riesgo que conllevan a estos indicadores no favorables. Conclusiones: los indicadores del Programa Materno Infantil miden la calidad de vida de una nación, a pesar de todas las estrategias tomadas por el Ministerio de Salud Pública existen algunos resultados que hay que revertir como las muertes fetales, por lo que se requiere de más trabajo desde la Atención Primaria de Salud haciendo énfasis en la promoción y la prevención, trabajar con intención los protocolos de actuación en dicho programa(AU)

Introduction: the Maternal and Child Program is a very sensitive program in the health sector since it declares comprehensive care for pregnant women, mothers, children and adolescents. Fetal mortality rates in children under one year of age and low birth weight are indicators that reflect the living conditions of women; the underlying morbidity and quality of life of a society. Objective: to determine the behavior of these two indicators in the municipality of Campechuela during the years 1980 to 2018, a period of 39 years. Methods: a retrospective, descriptive, observational study was carried out. The universe included all the births in Campechuela in the study years, deaths in children under 1 year of age, fetal deaths and low birth weight. The results expressed in absolute frequencies, relative frequencies and rates were represented. Through the use of descriptive statistics techniques. Results: the birth rate has decreased throughout the period under study with variations over time, the infant mortality rate has had a considerable decrease, not being the case, the low weight that has fluctuated, and fetal deaths have behaved in a different way. In an unfavorable way, the results allow us to assess that it is necessary to further intensify the control and monitoring of this prioritized group, and to increase the investigation of the risk factors that lead to these unfavorable indicators. Conclusions: the indicators of the Maternal and Child Program measure the quality of life of a nation, despite all the strategies taken by the Ministry of Public Health there are some results that must be reversed, such as fetal deaths, so more work is required from Primary Health Care, emphasizing promotion and prevention, working with intention the protocols of action in said program(EU)

Improving maternal and child nutrition in China: an analysis of nutrition policies and programs initiated during the 2000-2015 Millennium Development Goals era and implications for achieving the Sustainable Development Goals.

BACKGROUND: Although good progress was made in maternal and child nutrition during the Millennium Development Goals (MDGs) era, malnutrition remains one of the major threats on global health. Therefore, the United Nation set several nutrition-related goals in the Sustainable Development Goals (SDGs). There is much to be learned from individual countries in terms of efforts and actions taken to reduce malnutrition. China, as a developing country, launched a number of nutrition improvement policies and programs that resulted in dramatic progress in improving maternal and child nutrition during the MDGs era. This study explored the impact, experiences, and lessons learned from the nutrition policies and programs initiated in China during the MDGs era and implications to achieve the SDGs for China and other developing countries. METHOD: The CNKI database and official websites of Chinese government were searched for reviews on nutrition-related policies and intervention programs. A qualitative study was conducted among key informants from the Chinese government, non-governmental organizations (NGOs), and universities for two major national nutrition intervention programs. RESULTS: The literature review documented that during the MDGs era, six nutrition policies and eight trans-province and nationwide nutrition intervention programs collectively made good progress in improving maternal and child nutrition in China. Nutrition policies tended to be targeted at infants and children, with less attention on reproductive and maternal nutrition. Nutrition intervention programs focused primarily on undernutrition and have achieved positive results, while for breastfeeding improvement and prevention and control on overweight and obesity were limited. Results from the qualitative study indicated that effective nutrition program implementation was facilitated through the cooperation of multiple sectors and by the government and NGO partnerships, however, still face challenges of insufficient operational funds from local governments and inadequacy of program monitoring and management. CONCLUSION: Nutrition policies and intervention programs promulgated in China during the MDGs era have made major contributions to the rapid decline of undernutrition and are in line to achieve the SDGs related to child wasting, stunting, low birth weight, and anemia in reproductive-age women. However, appropriate policies and program implementation are needed to improve exclusive breastfeeding rates and reduce obesity to achieve the SDGs in years to come.

Applying a Client-centered Approach to Maternal and Neonatal Networks of Care: Case Studies from Urban and Rural Nigeria.

In Nigeria, two maternal and neonatal health Networks of Care (NOC) focus on extending the reach and quality of routine and emergency maternal and neonatal health services tailored to the different contexts. This paper uses the four domains of the NOC framework-Agreements and Enabling Environment, Operational Standards, Quality, Efficiency and Responsibility, and Learning and Adaptation-to describe the NOC, highlighting how each developed to address specific local needs. In Northern Nigeria, the NOC were established in collaboration among Clinton Health Access Initiative and the government to reduce maternal and neonatal morbidity and mortality. Health centers and communities in the network were supported to be better prepared to provide maternal and neonatal care, while birth attendants at all levels were empowered and equipped to stabilize and treat complications. The approach brought services closer to the community and facilitated rapid referrals. The NOC in Lagos State extended the reach of routine and emergency maternal and neonatal health services through organically developed linkages among registered traditional birth attendant clinics, private and public sector facilities, the Primary Healthcare Board, and the Traditional Medicine Board. Traditional birth attendants are registered, trained, and monitored by Apex Community Health Officers, whose responsibilities include collection and review of data and ensuring linkages to postpartum services, such as family planning and immunizations. While differing in their approaches, both NOC provide locally appropriate, pragmatic approaches to supporting women birthing in the community and encouraging institutional delivery to ensure that women and their babies have access to timely, appropriate, and safe services.

Maternal-child nursing care for adolescent mothers: health education.

OBJECTIVES: to develop an educational intervention through a game that addresses aspects related to adolescent motherhood and child care. METHODS: this is an action research based on diagnosis, intervention and apprehension stages. RESULTS: the situational diagnosis was based on a literature review on adolescent motherhood and child care. In the intervention stage, the educational game's first version was elaborated. In the third stage constituted by apprehension, the game was submitted to assessment of interdisciplinary experts. Suggestions of experts were adopted and the game had its second version. FINAL CONSIDERATIONS: the educational intervention in the present study appears a care technology that adds knowledge and practices to the work of nurses in Primary Health Care, focusing on adolescent women and children health care.

Health professionals and patients' perspectives on person-centred maternal and child healthcare in Burkina Faso.

CONTEXT: The person-centred approach (PCA) is a promising avenue for care improvement. However, health professionals in Burkina Faso (hereafter referred to as caregivers) seem unprepared for taking into consideration patients' preferences and values in the context of healthcare provision. OBJECTIVE: To understand the meaning attributed to PCA in the Burkina Faso context of care and to identify the challenges related to its adoption from the perspective of caregivers and women service users (hereafter referred to as patients). METHODS: An ethnographic qualitative research design was used in this study. We conducted 31 semi-directed interviews with caregivers and patients from Koudougou (Burkina Faso) healthcare facilities. We also carried out direct observation of consultations. Data thematic analyses are based on the person-centred approach analysis framework. RESULTS: According to the caregivers and patients interviewed, the PCA in maternal and child healthcare in Burkina Faso includes the following five components used in our analytical framework: i) pregnancy follow-up consultations extend beyond examining physical health issues (biopsychosocial component), ii) healthcare professionals' mood affects the caregiver-patient relationship as well as care delivery (the healthcare professional as a person), iii) patients expect to be well received, listened to, and respected (the patient as a person), iv) healthcare professionals first acknowledge that both themselves and patients have power, rights but also responsibilities (sharing power, rights and responsibilities of professionals and patients), and v) healthcare professionals who are open to involving patients in decision-making about their care and patients asking to have a say in the organization of services (therapeutic alliance). Implementing each of these themes comes with challenges, such as i) talking about health problems in the presence of other women, especially those related to sexuality, even though they are common to parturient women (biopsychosocial component); ii) offering psychotherapy to healthcare professionals (healthcare professional as a person); iii) taking into consideration patients' cultural and linguistic differences (the patient as a person); iv) raising awareness among patients about their right to ask questions and healthcare professionals' duty to answer them (sharing power, and rights and responsibilities of professionals and patients); v) accepting the presence of birth attendants while avoiding traditional practices that are contrary to scientific recommendations (therapeutic alliance). CONCLUSION: Despite some context-specific particularities, the PCA is not new in the context of health care in Burkina Faso. However, its implementation can pose a number of challenges. There is a need to train healthcare professionals with a view to being sensitive to these particularities. This may also require organizational adjustments so as to create the physical and sociocultural environments that are conducive to taking into account the patient's perspective.

Factores de riesgo que influyen en el conocimiento sobre lactancia materna. Área de salud Bueycito. 2018 / Risk factors that influence knowledge about breastfeeding. Bueycito health area. 2018

Introducción: la lactancia materna exclusiva (LME), es definida como la alimentación basada exclusivamente en la leche materna, aportando beneficios tanto para el/la hijo/a como para la madre, a corto y largo plazo. Objetivo: identificar los factores de riesgo bio-sociales que influyen en el conocimiento sobre lactancia materna exclusiva en gestantes del área de salud Bueycito, municipio Buey Arriba, Granma. Método: se realizó un estudio descriptivo retrospectivo de caso-control, con el propósito de conocer los factores de riesgo relacionados con el conocimiento sobre lactancia materna exclusiva en gestantes del área de salud Bueycito del municipio Buey Arriba, Granma, en el año 2018. Resultados: se estudiaron 67 gestantes, en el grupo caso, el desconocimiento sobre lactancia materna exclusiva fue más frecuente en menores de 20 años, con nivel secundario, y según lo referido por no planificar el embarazo, y por consiguiente no haberse preocupado por conocer sobre lactancia materna. Conclusiones: se encontró un porcentaje muy alto de gestantes con poco o ningún conocimiento sobre lactancia materna exclusiva, relacionado con el nivel educacional, la edad y la ocupación de las gestantes estudiadas(AU)

Introduction: exclusive breastfeeding (SCI) is defined as feeding based exclusively on breast milk, providing benefits for both the child and the mother, in the short and long term. Objective: to identify the bio-social risk factors that influence knowledge about exclusive breastfeeding in pregnant women in the Bueycito health area, Buey Arriba municipality, Granma. Method: a retrospective case-control descriptive study was carried out, with the purpose of knowing the risk factors related to knowledge about exclusive breastfeeding in pregnant women in the Bueycito health area of the Buey Arriba municipality, Granma, in 2018. Results: 67 pregnant women were studied, in the case group the lack of knowledge about exclusive breastfeeding was more frequent in children under 20 years of age, with secondary level, and as referred for not planning the pregnancy, and therefore not having worried about knowing about breastfeeding maternal. Conclusions:a very high percentage of pregnant women was found with little or no knowledge about exclusive breastfeeding, related to the educational level, age and occupation of the pregnant women studied(EU)

Integration of Maternity and Neonatal Care to Empower Parents.

OBJECTIVE: To describe the transition from a traditional hospital design with separate maternity and neonatal departments to a design in which maternity and neonatal health care infrastructures are integrated to empower parents. DESIGN: A descriptive, qualitative analysis. SETTING: A mother and child center in a teaching hospital in Amsterdam. PARTICIPANTS: Six staff members who were involved in the transition. METHODS: We analyzed the content of all relevant policy reports and other related documents that were produced during the transition from April 2010 to October 2014. This content was supplemented with in-depth, semistructured interviews with the six participants. We used thematic analysis and Bravo et al.'s model of patient empowerment to analyze the documents and the qualitative interview data. RESULTS: We identified eight themes. At the health care system level, the four themes were Joint Vision and Goal, Integration of Three Wards Into One With Single-Family Rooms, Reorganization of the Health Care Team, and New Equipment. At the health care provider level, the three themes were Training for Extension of Professional Goals, Intensified Coaching for Parents, and Implementing Patient Centeredness. The single theme at the patient level was Opinions and Experiences of Parents. CONCLUSION: We found a good fit between the new design and Bravo et al.'s model of patient empowerment. Challenges that remain include the adaptation of staff training programs and further development of the infrastructure in collaboration with staff and parents. The experiences of parents and staff members will be evaluated in future studies.

Does gender equality and availability of contraception influence maternal and child mortality? A systematic review.

BACKGROUND: Current global maternal and child health policies rarely value gender equality or women's rights and are restricted to policies addressing clinical interventions and family planning. Gender equality influences the knowledge, autonomy and utilisation of contraception and healthcare, thereby affecting maternal and child health. This systematic review aims to analyse the concurrent effect of gender equality and contraception on maternal and under-5 child mortality. METHODS: A systematic review was conducted to investigate the current evidence. Studies were eligible if three themes-namely, indicators of gender equality (such as female education, labour force participation, gender-based violence), contraception, and maternal or child mortality-were present together in a single article analysing the same sample at the same time. RESULTS: Even though extensive literature on this topic exists, only three studies managed to fit the selection criteria. Findings of two studies indicated an association between intimate partner violence (IPV) and infant mortality, and also reported that women's contraceptive use increased the risk of IPV. The third study found that the mother's secondary education attainment significantly reduced child mortality, while the mother's working status increased the odds of child mortality. The researchers of all included studies specified that contraceptive use significantly reduced the risk of child mortality. CONCLUSION: Improvement in gender equality and contraception concurrently affect the reduction in child mortality. These findings provide strong support to address the research gaps and to include a gender equality approach towards maternal and child health policies.

Curso de aprimoramento para enfermeiras obstétricas do Projeto Apice On: relato de experiência / Curso de perfeccionamiento para enfermeras obstétricas del Proyecto Apice On: relato de experiencia / Improvement course for obstetric nurses of the Apice On Project: an experience report

Resumo Objetivo relatar as experiências práticas vivenciadas no Curso de Aprimoramento para Enfermeiros Obstetras do projeto Apice On do Ministério da Saúde. Método estudo descritivo na modalidade relato de experiência. Os relatos foram colhidos a partir de uma pergunta norteadora em um encontro virtual das autoras. Resultados as reflexões foram agrupadas em duas principais temáticas: 1) O potencial da Enfermagem Obstétrica e 2) O cuidado como elemento principal da assistência. Conclusão e Implicações para a prática o curso é uma estratégia nacional de grande impacto para o empoderamento e visibilidade da categoria profissional da Enfermagem Obstétrica. O aprimoramento possibilitou, às enfermeiras participantes, a aquisição de habilidades práticas e segurança técnica, além de motivá-las à construção de estratégias para a superação dos modelos obstétricos que não estão alinhados às atuais recomendações científicas.

Resumen Objetivo reportar las experiencias prácticas vividas en el Curso de Mejoramiento para Enfermeras Obstétricas del proyecto Apice On del Ministerio de Salud. Método estudio descriptivo en la modalidad de informe de experiencia. Los informes se recopilaron de una pregunta orientadora en una reunión virtual de los autores. Resultados las reflexiones se agruparon en dos temas principales: 1) El potencial de la enfermería obstétrica y 2) El cuidado como elemento principal de la atención. Conclusión e Implicaciones para la Práctica el curso es una estrategia nacional de gran impacto para el empoderamiento y la visibilidad de la categoría profesional de Enfermería Obstétrica. La mejora permitió a las enfermeras participantes adquirir habilidades prácticas y seguridad técnica, y motivarlas a desarrollar estrategias para superar los modelos obstétricos que no están en línea con las recomendaciones científicas actuales.

Abstract Objective to report the practical experience lived in the Obstetric Nurses Improvement Course of the Apice On project of the Ministry of Health. Method descriptive study in the experience report modality. The reports were collected from a guiding question in a virtual meeting of the authors. Results the reflections were grouped into two main themes: 1) The potential of obstetric nursing and 2) Care as the main element of care. Conclusion an and Implications for practice the course is a national strategy of great impact for empowerment visibility of the professional category of Obstetrical Nursing. The improvement enable the participating nurses to acquire practical skills and technical safety, and motivate them to build strategies to overcome obstetric models that are not in line with current scientific recommendations.

Maternal-child nursing care for adolescent mothers: health education / Atención de enfermería materno infantil para madres adolescentes: educación en salud / Cuidado de enfermagem materno-infantil para mães adolescentes: educação em saúde

ABSTRACT Objectives: to develop an educational intervention through a game that addresses aspects related to adolescent motherhood and child care. Methods: this is an action research based on diagnosis, intervention and apprehension stages. Results: the situational diagnosis was based on a literature review on adolescent motherhood and child care. In the intervention stage, the educational game's first version was elaborated. In the third stage constituted by apprehension, the game was submitted to assessment of interdisciplinary experts. Suggestions of experts were adopted and the game had its second version. Final Considerations: the educational intervention in the present study appears a care technology that adds knowledge and practices to the work of nurses in Primary Health Care, focusing on adolescent women and children health care.

RESUMEN Objetivos: desarrollar una intervención educativa a través de juego relacionadas la maternidad en la adolescencia y cuidado de lo niño. Métodos: se trata de una acción, basada en etapas de diagnóstico, intervención y aprehensión. Resultados: la investigación situacional fue realizada una revisión de literatura sobre la maternidad la adolescencia y el cuidado del niño. La primera etapa de la classe elaboró primera versión del juego educativo. En la tercera etapa, preparada la aprehensión, el juego fue sometido a la apreciación de especialistas interdisciplinarios. Las sugerencias de las solicitudes se aprobaron y el juego se ganó segundo. Consideraciones Finales: la intervención educativa elaborada em presente estudio configura una tecnología de cuidado que agrega saberes y prácticas para trabajo del enfermero en la Atención Primaria de Salud, con énfasis en la atención de salud la mujer adolescente y del niño.

RESUMO Objetivos: desenvolver uma intervenção educativa por meio de um jogo com abordagem de aspectos relacionados à maternidade na adolescência e cuidado da criança. Métodos: trata-se de uma pesquisa ação baseada nas etapas de diagnóstico, intervenção e apreensão. Resultados: o diagnóstico situacional foi pautado em uma revisão de literatura sobre maternidade na adolescência e cuidado da criança. Na etapa da intervenção, foi elaborada a primeira versão do jogo educativo. Na terceira etapa, constituída pela apreensão, o jogo criado foi submetido à apreciação de especialistas interdisciplinares. As sugestões dos especialistas foram adotadas e o jogo ganhou sua segunda versão. Considerações Finais: a intervenção educativa elaborada no presente estudo configura uma tecnologia de cuidado que agrega saberes e práticas ao trabalho do enfermeiro na Atenção Primária à Saúde, com foco nos cuidados de saúde da mulher adolescente e da criança.

Channeling Our Legacy into Our Future: The Importance of the MCH Pipeline Training Program.

The MCH Pipeline Program, created in 2006, creates an important opportunity to identify and encourage undergraduate students from underrepresented populations to consider career paths in maternal and child health. These programs provide didactic instruction, experiential learning, and mentorship to a diverse group of young scholars in order to both enhance their opportunities to pursue graduate or professional degree training in the myriad professions that make up the MCH workforce and to provide them with essential grounding in the history, context and mission of MCH. The leaders of the funded programs meet periodically to exchange ideas; on this occasion, the author was asked to address the group responding to the question "what knowledge or skills are critical for emerging undergraduate scholars?". Placing these programs squarely in their historical context, her remarks are provided here to encourage others to consider developing programs for undergraduate students who may be enlisted to join the MCH profession.