Some experiences in the whole world, including the famous experience of Galba Arajo in the state of the Cear, had called the attention for the possibility, respecting the local culture and traditions, to provide some degree with training to the traditional obstetricians, over all in the area of recognition of the situations of risk for the opportune reference the enabled centers more. The idea was of that, in the impossibility to all recommend and to construct a system integrated and adjusted of attention to the gestation and birth in these localities, important the traditional obstetricians could be assistant in the identification of risks during the pregnancy and the childbirth, transferring the women to maternities of reference (MOURA; IT HISSES, 2004). These would have to be in tune with these professionals to receive, to guide and to deal with the case, being also respected the judgment and the attendance given for the traditional obstetrician. This idea was likeable for the international, professional organizations and governments of the countries with limited resources for investment in the attention to the health, and was stimulated and implemented during decades, but without a multicriteria evaluation and metodologicamente carried through well on its effectiveness. Unhappyly, the available knowledge most recent on the programs of training and integration of the traditional obstetricians to the system of attention to the gestation and childbirth, although the potential benefits for the health materna and perinatal, have not demonstrated to impact in the reduction of mortality materna. The probable necessity of integrated essential obsttricos services, beyond efficient, including the necessity of constant availability of transports, frequently not fully available systems of reference in the reality of the agricultural and poor regions of the developing countries, materna (MOURA must be main responsible for this the low impact in the reduction of mortality; IT HISSES, 2004). Thus, as resulted of these evaluations, the recommendation most frequent it is of that the governments and the public institutions of health they would have to give preference, in the use of resources destined to the training of professionals for the attention to the gestation and the childbirth, the professionals most qualified and with bigger degree of formal instruction, since thus the impact on the reduction of mortality materna is bigger.
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