Promotion of Quality of Care in Brazilian Maternities: A Case Report

The National Agency of Health Surveillance (ANVISA) is a Brazilian regulatory agency entailed to the Ministry of Health. Its institutional purpose is to promote the population health through the sanitary control of the production and commercialization of products and health services subject to sanitary surveillance. To achieve its goals, ANVISA defines rules for health services and monitor health services risks. One of the priorities of Brazilian National Health System is to decrease our high level of maternal mortality. To collaborate with this, ANVISA organized a network team to elaborate rules for maternities, trying to work out a democratic and evidence-based process of regulation. This work discusses the experience of ANVISA during the development of rules for Brazilian maternities. ANVISA created a work team, including representation of Ministry of Health, National Agency for Supplementary Health Services, scientific society, organizations of the civil society, nursing professionals, obstetrics professionals and pediatrics professionals. This team worked for months in a proposal of rules, which were based on quality and humanization of care. The result was published and available in the ANVISA’s site for everyone that would like to give recommendations. The same work team analyzed the contributions and published a final version of this regulamentation, shared in two documents. One includes topics related to the structure and organization of the service, as the right of every woman to have a companion during the childbirth. The other document presents indicators of quality that every service must use as an instrument of evaluation, like cesarean rates. This experience evidences the importance of a regulatory health agency that follows the same direction as the national health policy and promotes the integration of different institutions with responsibility to combat maternal mortality.