Obstetric care in a migrant population with free access to health care.

OBJECTIVE: To evaluate differences in obstetric care between immigrant and native women in a country with free access to health care. METHODS: A cross-sectional study was carried out of immigrant mothers delivering in one of the four public hospitals in the Porto, Portugal, metropolitan area between February and December 2012. The comparison group included native Portuguese mothers who delivered in the same institutions. The participants (89 immigrant mothers and 188 Portuguese mothers) were recruited by telephone and completed a written questionnaire during a home visit. RESULTS: Immigrant women were more likely to have their first pregnancy appointment after 12 weeks of pregnancy (27.0% vs 14.4%, P = 0.011) and to have fewer than three prenatal visits (2.2% vs 0.0%, P < 0.001). They were also more likely to have had a cesarean delivery (48.3% vs 31.4%, P = 0.023), perineal laceration (48.8% vs 11.6%, P < 0.001), or postpartum hemorrhage (33.5% vs 12.3%, P < 0.001). CONCLUSION: Migrants were more prone to late prenatal care and to intrapartum complications. Unsatisfactory interactions with healthcare staff may play an important role in these findings.

Avaliaçäo das açöes de controle da infecçäo esquistossomótica nas localidades de Cachoeira-Bahia, bacia do Paraguaçu, 1982-1992 / Evaluation of the effectiveness of the schistosomiasis control program in the locality of Cachoeira-Bahia, in Paraguaçú Basin area, 1982-1992

This study evaluates the effectiveness of the Schistosomiasis Control Program, PCE, in Cachoeira, state of Bahia-Brazil, in Paraguaçu Basin Area. Data comes from PCE-111 cards of SUCAM/FNS, which are routinely registered in the 111 villages identified during the study follow up, 1982-1992. The S. mansoni infection was diagnosed through Katz-Kato technique for stool exams. Temporal trends of the prevalence of infection were analyzed for each village. Four trend patterns were identified, and the most common was those of recurrence of infection prevalence (67.6 per cent). Control of the endemics was achieved in 22.5 per cent of the villages, while expansion trends were found in only 9.9 per cent of them. In general, there was found a decrease in the prevalence, particularly, from 1982 to 1985, followed by an increase that do not reach the initial levels. It was observed a relative reduction on the number of villages that shows prevalence below or equal to 5 per cent, that indicates control of the infection. It was not possible to evaluate trends of infection intensity neither the occurrence of severe shistossomiasis disease or related deaths, that may allow a more complete evaluation of this program.