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Mãe Curitibanas Program
Secretaria Municipal da Saúde Curitiba Paraná -
Brazil
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Curitiba Paranain the south of Brazil

• population 1.6 million

• 104 health units
• 13 maternity hospitals SUS (NHS)

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In Curitiba

• 29 thousand live births per year of resident
  women
• before the Program
• 30 of the pregnant women could not find a
  hospital bed when in labour

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Different needs

• what did the pregnant women want?
• a safe labor
• good quality of care
• what did the health authorities want?
• to reduce the vertical transmission of HIV,
  syphilis and toxoplasmosis

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Antenatal Care

• a new ANC technical protocol
• a communication sub -project

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Antenatal Care

• the ANC protocol included
• guaranty of maternity ward referral
• at least 6 medical consultations

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Antenatal Care

• the ANC protocol included
• routine testing and treatment for HIV,
  toxoplasmosis and syphilis

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Antenatal Care

• home visits with the nurse staff or the community
  health agents

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Antenatal Care

• visit to the maternity ward in the 6 ou 7 month

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Antenatal Care

• the communication sub-project included the
  design of

• a logo
• an educational booklet
• a handbag

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Antenatal Care

• the communication sub-project included

• technical training of the health professionals

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Antenatal Care

• organization of 24 educational workshops

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Results 1999 and 2000

• increase in the number of pregnant women
  attending the PHC units
• 30 em 1999
• 97 em 2000

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Results 1999 and 2000

• decrease in maternal mortality

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Results 1999 and 2000

• reduction of the vertical transmission of
  syphilis and toxoplasmosis

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Results 1999 to 2001

• detection of HIV in pregnancy
• 88 tested (41679 exams)
• 387 HIV
• 0.93

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Results 1999 and 2000

• reduction of mother to child HIV transmission

1999 5.9 2000 5.2
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Results

• increased satisfaction pregnant women and
  health professionals

95 of the women enrolled were satisfied with the
program
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Lessons learned

• integration with a good ANC program is essential
  to the success of a PMTCT of HIV/Aids

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Lessons learned

• the Primary Health Care Units / professionals are
  able to deal with the problem of HIV in their
  community

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Mãe Curitibana

• the future is built in the present