Effectiveness of antenatal and well-baby care in primary health services from Brazilian south and northeast regions

OBJECTIVES: the effectiveness of antenatal and well-baby programs was assessed in a sample of 4078 mothers and children living in the coverage area of Primary Health Care Services. Stratified by geographic region (South and Northeast) and primary care model (family health and traditional services), in 41 municipalities over to 100,000 inhabitants. METHODS: it was made a cross sectional study with compararison groups and differrent aggregation levels of analysis. RESULTS: in the Northeast the availability of antenatal care was universal in both models. In the South, it was significantly greater in the family health services. The well-baby care was more available in the family health services, in both regions, as well as the counseling groups. The antenatal and well-baby care guidelines were less used in the Traditional primary care services. The health workers from the family health services referred more participation in up date training, in both regions. Around 40 percent of mothers and a half of babies were covered by the primary health care from their neighborhood. However, considering four or more visits during antenatal care and nine or more visits during the first year of life, the coverage drops to 31 percent for mothers and 20 percent for babies. The effectiveness of well-baby care was greater in the family health program only in the Northeast, regarding the Traditional services. CONCLUSIONS: the effectiveness was progressively smaller from the availability of antenatal and well-baby programs, through professional training and guideline utilization, until population coverage.