THE WOMAN INTEGRAL HEALTH ASSISTANCE PROGRAM IN GOIÂNIA: the (un) institutionalization in the

Abstract

This paper aims to study the ideological, programmatic and operational determinant of the (un) institutionalizationof the prenatal nursing consultation in Goiânia, in the Woman Integral Health Assistance Program context. Thedata were obtained through the analysis of documents and of the testimony content of twelve women interviewed,occupants of central and local level hierarchical positions, as well as of assisting nurses. The analysis used adialectical approach aided by the gender concept and its relation with the reproductive health and with nursing. Theresults, contextualized mainly in the political, social and economical crisis of the country and in the high maternaland perinatal mortality rate, which confirm, a prevailing pattern of technical and medical assistance, and in theother hand, the different ways of woman’s prenatal care given by the nurse through Nursing Consultation, wherethe medical resistance pattern prevails upon autonomy and professional proficiency. The nurse accomplishes onlythe first prenatal consultation. The physician accomplishes all the subsequent ones, complying with an assistancerule of the public system Units. It has been verified that among the difficulties, there is no clearness in therelationship between the central and local level authorities; the traditional education reinforces the traditionalworking process; the working conditions are deficient; there is no physical room for nursing consultation; theresources are insufficient to implement actions and there is little prenatal assistance given by the nurse. However,there are positive paths such as the indication of a nurse for the management team of the Woman Integral HealthAssistance Program, the Technical Management of the Units, programmatic educational actions, and theimprovement in the reflection about tendencies and perspectives as well as of the professional ethical dimension.