The new Mãe Santista program: quality care for pregnant women during prenatal, delivery e postpartum

                                                              

The new Mãe Santista program: quality care for pregnant women during prenatal, delivery e postpartum

Comunitas
Solution proposed by: 
Comunitas, Santos City Hall and Tellus Institute
In a Nutshell: 
A program focused on reduces the infant mortality. It was reformulated with participation of pregnant women from the community in order to establish a new standard of healthcare. It provides integral and humanized assistance from the prenatal till the baby complete 1 year old to the municipal health network users.
Where and When: 
It has been developed since January 2015, in the city of Santos, which is located in the state of São Paulo, Brazil
Challenges: 
Data from SEADE (State System Foundation Data Analysis) indicated that since 2000, Santos had the worst infant mortality rate in the state of São Paulo. The average rate in 2013 was 15.65 per thousand inhabitants, which means that for every thousand newborns nearly 16 children did not survive until the first year of life. The challenge was to create a friendly and effective service for pregnant women and mothers with children up to 1 year, which would raise the standard of quality of care and reduce the mortality rate to single digits.
Innovation: 
Through the Design Thinking method, the opportunities for improvement of services offered to women were mapped. There were more than 90 meetings, visits and workshops with the servers of the Department of Health and users, which led to 21 solutions to be implemented as part of the New Mãe Santista program. The three main structural actions are: the School Mother; the Escola das Mães (School Mother) app; and the New Mãe Santista kit. The School Mother app is the first in Brazil aimed at this audience to be offered by a municipal government.
Concept: 
In the new Mãe Santista program was established that the mother would be the focus of care. The service to be offered in health facilities comprise all stages of pregnancy: reproductive planning; prenatal; childbirth and postpartum. All in one place - previously, services were offered in different equipment, that is not talking, and the user was passive in this process. The program proposes the creation of a continuous line of care to pregnant women, connecting everyone involved in the pregnancy journey (before, during and after birth), such as family, partner, community, school, Department of Health, hospital, house mother and Basic Health Unit. It was proposed four main areas of project performance: (1) the public health system integration (secure link with the network and strengthen the importance of breastfeeding), (2) Analysis for Action (dialogues between network devices, host and humanizing), (3) Interdisciplinary Diagnosis (continuous rating of the risk of pregnancy, services for pregnant women who do not adhere to prenatal consultations and practical training for pregnancy) and (4) Recovery and continuous Care Servers (reproductive planning, prevention of unwanted pregnancy and promote self-perception of shares).
Description: 
The city of Santos created the Mãe Santista program in 2013 and in an attempt to complement the actions to reduce infant mortality made the partnership with Comunitas organization that through the program Juntos pelo Desenvolvimento Sustentável (Together For Sustainable Development) develops focused actions on innovating and Improving local government. The Comunitas enlisted the expertise of Tellus Institute, which was responsible for involving users, public servants and managers in the co-creation processes. After the partnership with Comunitas the program was redesigned with the aim of improving the standard of care, expanding the service network and extend the lines of care with mother and baby up to one year after birth. With the new Mãe Santista three major actions were taken: (1) New Mãe Santista kit - when you start prenatal care in the public system, all pregnant women receive a storage bag tests, booklet and explanatory brochures. At the end of pregnancy they will receive a layette for the baby and a layette for pregnant women with personal hygiene items and condoms. (2) School Mother: It is a set of educational activities that complement the medical consultations and prepare women and their support network for motherhood. The content addresses reproductive health, pregnancy and other topics of interest. The approaches are less expository and more practical, based on the experience of users. The activities are geared for both pregnant women and women who do not think about getting pregnant, in addition to partners and family. (3) School Mother app: It is the first application targeted to pregnant women offered by Brazil City Hall. The application gathers the summaries of activities carried out in health facilities and information according to the user profile (pregnant, non-pregnant and newborn's mother), such as contraception, sexuality, nutrition during pregnancy, childbirth and types preparation for breastfeeding.
Impacts: 
Reducing child mortality is a commitment of the current governance of Santos. In 2013, the infant mortality rate in the county was 15.65 per thousand inhabitants. At the end of 2014 to Santos Child mortality rate dropped to 10.8 per thousand live births, the lowest in the history of the city, according to a survey of SEVIG-MMI (Surveillance Section of Maternal Infant Mortality). The expansion of the Mãe Santista program will work to achieve the goal of the government to reduce the infant mortality rate to below 10 per 1000 live births, as determined by the World Health Organization (WHO).

Photo Gallery

Escola das Mães website
Co-creation workshop – Tellus Institute Collection
Mothers with the new kit of Mãe Santista program / Photographer: Anderson Bianchi / City Hall Santos
Mayor speaking to audience in the new Mãe Santista program launch / Photographer: Anderson Bianchi / City Hall Santos