SciELO - Scientific Electronic Library Online

 
vol.39 issue1Health services utilization in areas covered by the family health program (Qualis) in Sao Paulo City, BrazilQuality of life and depression in women abused by their partners author indexsubject indexarticles search
Home Page  

Revista de Saúde Pública

Print version ISSN 0034-8910

Abstract

LEAL, Maria do Carmo; GAMA, Silvana Granado Nogueira da  and  CUNHA, Cynthia Braga da. Racial, sociodemographic, and prenatal and childbirth care inequalities in Brazil, 1999-2001. Rev. Saúde Pública [online]. 2005, vol.39, n.1, pp. 100-107. ISSN 0034-8910.  http://dx.doi.org/10.1590/S0034-89102005000100013.

OBJECTIVE: To analyze social inequalities and inequalities in access to and utilization of health care services according to skin color in a representative sample of postpartum women receiving hospital childbirth care. METHODS: A cross-sectional study was carried out in a sample of 9,633 postpartum women, of whom 5,002 were white (51.9%), 2,796 mulatto (29.0%), and 1,835 black skin color (19.0%), seen in public maternity hospitals, hospitals contracted out by the Unified National Health System, and private hospitals in the period 1999-2001. Data were collected from medical records and through interviews with the mothers in the immediate postpartum period using standardized questionnaires. Statistical analyses were performed using c² tests to assess homogeneity of proportions and Student's t-test for comparison of measures. The analysis was stratified by maternal schooling. RESULTS: A persistent unfavorable situation was seen for mulatto and black women as compared to white women. Mulatto and black women had the highest rates of adolescent mothers, low schooling, unpaid occupation, and not having a partner. History of physical violence, smoking, attempts to interrupt pregnancy, and visits to several hospitals before being admitted were more frequent among black women, followed by mulatto and then white women of low schooling. High schooling group of women showed better indicators but the same pattern was seen. This variability is also seen in the opposite direction in terms of the level of satisfaction with prenatal and childbirth care. CONCLUSIONS: It was distinguished two forms of discrimination, by educational level and skin color, in care delivered by health services to postpartum women in Rio de Janeiro.

Keywords : Prenatal care; Postnatal care; Social inequity; Health services accessibility; Equity in access.

        · abstract in Portuguese     · text in English | Portuguese     · pdf in English | Portuguese