Análise do grau de implantação do Método Canguru em Salvador, Bahia: experiências de duas maternidades públicas de referência.

Abstract

Children with a birth weight below 2500 grams and prematurity are associated with an increased risk of functional sequelae, the need for specialized attention, and a higher risk of mortality. The Kangaroo Mother Care method is considered a light, low-cost, and easily operational technology, aiming to improve care and reduce neonatal morbidity and mortality. Through a biopsychosocial approach to the newborn and their family, the procedure focuses on early skin-to-skin contact, exclusive breastfeeding upon discharge, and early hospital discharge with outpatient follow-up. This dissertation aimed to analyze the degree of implementation of the Kangaroo Mother Care method in two public maternity hospitals in Salvador (BA) and was structured in the form of two articles. The first article had a theoretical-methodological nature in three stages. Its objective was to validate an operational logical model of the Kangaroo Mother Care Method and an evaluative matrix of the degree of implementation of this policy. After a literature review on Pubmed and Scielo databases and legal regulations, the logical model and matrix underwent expert consensus through the Delphi technique, resulting in the validation of 25 criteria. The second article aimed to analyze the degree of implementation of the Kangaroo Mother Care method in two public maternity hospitals in Salvador (BA) through a validated evaluation matrix. An evaluative research of the implementation degree was conducted from August 2021 to October 2022, through the triangulation of information obtained from interviews with key actors and non participant observation. The sample consisted of 29 mothers with hospitalized newborns, 43 healthcare professionals, and 2 individuals involved in the management of the Kangaroo Mother Care Method. According to the evaluative matrix, the structure and processes of the studied method were considered partially implemented. Facilitators included ensuring a suitable environment for the mother's 24-hour stay in the maternity ward, the involvement of psychology and social services as mediators for this stay, and the availability of the pregnant woman's house, baby's house, and puerperal woman's house. Weaknesses included workload overload of professionals with weakened employment ties, low adherence to recommended care practices, and the clinical complexity of hospitalized newborns. The use of the matrix supported the detection of potential strengths and weaknesses, which could be used to adjust care and managerial practices related to the Kangaroo Mother Care method.