Postnatal and postabortion care during adolescence in the National Health System in Rio de Janeiro, Brazil.
OBJECTIVE
To study postnatal and postabortion outpatient care for adolescents in relation to the guidelines of the Brazilian Ministry of Health.


METHODS
The present cross-sectional study was conducted between 2011 and 2012 via interviews with coordinators from 147 of 148 (99.3%) National Health System facilities providing sexual and reproductive healthcare for adolescents in the city of Rio de Janeiro, Brazil. The χ(2) test or Fisher exact test was used to compare ratios, and t test to compare means, with a significance level of 5% (P<0.05).


RESULTS
Postnatal care was provided by 141 (95.9%) facilities; however, only 95 (67.4%) facilities complied with the guidelines of the Ministry of Health by providing two consultations: one in the first week and one between the 30th and 42nd day postpartum. In 32 (22.7%) facilities, a consultation was not scheduled in the first week; and in 25 (17.7%), a consultation between the 30th and 42nd day postpartum was not scheduled. Furthermore, only 11 (7.8%) facilities provided care in the age bracket recommended by WHO and the Brazilian Ministry of Health.


CONCLUSIONS
The provision of puerperal care in the Brazilian National Health System is currently far from the recommendations in government guidelines.
Children's and Women's Health, Fernandes Figueira Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Medical Sciences Graduate Program (PGCM), College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Perinatal Center, Pedro Ernesto University Hospital (HUPE), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Department of Gynecology and Obstetrics, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil. Electronic address: mariangelanb@ig.com.br.
Mariangela N
MN
Blanco
Medical Sciences Graduate Program (PGCM), College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Department of Internal Medicine, College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
Stella R
SR
Taquette
Children's and Women's Health, Fernandes Figueira Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Department of Gynecology and Obstetrics, College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Serra dos Órgãos University Center (UNIFESO), Rio de Janeiro, Brazil.
Denise L M
DL
Monteiro
Perinatal Center, Pedro Ernesto University Hospital (HUPE), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Department of Gynecology and Obstetrics, College of Medical Sciences (FCM), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
Fátima R D
FR
Miranda
D000028:Abortion, Induced; D000293:Adolescent; D000359:Aftercare / Q000592:standards; D000554:Ambulatory Care Facilities / Q000592:standards*; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D011181:Postnatal Care / Q000592:standards; D055815:Young Adult
Abortion; Adolescent; Contraception; Postnatal care