title: Access to prenatal care: assessment of the adequacy of different indices.
abstract: This study aimed to compare the evaluation of adequate access to prenatal care according to different indices. Data to construct the indices were obtained from 1,006 patient interviews, prenatal cards, and medical charts for postpartum women who had been admitted for childbirth at maternity hospitals in Greater Metropolitan Vitória, Espírito Santo State, Brazil, from April to September 2010. The various indices for the evaluation of prenatal care were compared to the Kotelchuck index (1994) as the standard reference. Prevalence rates for adequacy were calculated, as were agreement, sensitivity, specificity, predictive values, accuracy, and likelihood ratios. The Takeda index showed the highest prevalence of adequacy (55.8%). The highest agreement was between the indices proposed by Villar et al. and Rosen et al. (adjusted kappa = 0.84). The study concludes that the Carvalho & Novaes index and the Brazilian Ministry of Health index are relevant for assessing adequate access to prenatal care.
authors.affiliation: Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Brasil. edsontheodoro@uol.com.br
authors.forename: Edson Theodoro dos
authors.initials: ET
authors.lastname: Santos Neto
authors.forename: Adauto Emmerich
authors.initials: AE
authors.lastname: Oliveira
authors.forename: Eliana
authors.initials: E
authors.lastname: Zandonade
authors.forename: Maria do Carmo
authors.initials: Mdo C
authors.lastname: Leal
mesh_terms: D001938:Brazil; D005260:Female; D006297:Health Services Accessibility / Q000592:standards* / Q000706:statistics & numerical data; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D014505:Urban Population