Quality of prenatal care in public and private services

PURPOSE: To analyze prenatal care in public and private services. METHODS: A cross-sectional, retrospective and analytic study was conducted based on the audit of files of pregnant women who had given birth at a reference hospital for low risk cases in the area of Campos Gerais-Parana State, in the first semester of 2011. The Yates chi-squared test or exact Fisher test were used to determine the association between the lack of registration files for pregnant women regarding prenatal assistance in the public and private services, with the level of significance set at p=0.05. The quality of prenatal care was determined based on the percentile of non-registrations. RESULTS: A total of 500 prenatal files were analyzed. There was a significant attendance of six or more prenatal visits, with a larger proportion in the private service (91.9%). The laboratory and obstetric exams most frequently not registered in the public and in the private services were, respectively: hepatitis B (79.3 and 48.4%), hemoglobin and hematocrit values (35.6 and 21.8%), anti-HIV serology (29.3 and 12.9%), fetal movement (84.3 and 58.9%) and length (60.4 and 88.7%), edema verification (60.9 and 54.8%), and fetal presentation (52.4 and 61.3%). The audit of the files of pregnant women allowed to determine the quality of the prenatal care provided and confirmed differences in assistance according to the place, showing excellent and good quality of private care, and regular public care for ultrasonography and blood type/Rh factor; regular quality of private care and poor quality of public care for urine tests and weight. For the other types of laboratory and obstetric exams and vaccines, the quality was poor or very poor in both types of services. CONCLUSION: The differences between the services showed that there is a need for actions aiming at the improvement of the prenatal care provided by public services.