Gestão e atenção perinatal em serviços de saúde: desfechos da regionalização

Abstract

The fragmentation of perinatal care has prompted debates advocating for the organization of regionalized health services; however, little is known about the outcomes of this process for management and care delivery. This study aims to systematize the knowledge from international and national literature regarding the outcomes of health regionalization in perinatal management and care. It is a systematic review based on the PRISMA-ScR protocol, conducted through the databases PubMed, LILACS, SciELO, Web of Science, Scopus, and the CAPES Theses and Dissertations Catalog. The review was structured using the PICO strategy (Patient, Intervention, Comparison, and Outcome), which guided the formulation of the research question. The inclusion criteria comprised studies published between 2010 and 2025, in English and Portuguese, using the following descriptors: ‘Maternal-Child Health Services’; ‘Maternal-Child Health Centers’; ‘Birthing Centers’; ‘Perinatal Care’; ‘Regional Health Planning’; ‘Health Policy’, and their equivalents in Portuguese. The quality assessment of the articles was based on the Mixed Methods Appraisal Tool. A summary table was used to organize the data from the articles, through a spreadsheet developed in Excel. In terms of perinatal service management, the outcomes of regionalization were associated with strategies ranging from regional agreements to the involvement of maternal and child care management groups within obstetric units. Regarding perinatal care, the implications included initiatives for structuring levels of maternal care and the development of evidence-based best practices. This review identified significant outcomes that may inform potential evaluative categories for future implementation analysis studies.

Key Words: Perinatal Care. Health Management. Health Services. Regional Health Planning. Review.