“Parto humanizado” no Brasil: avaliação política do Programa de Humanização no Pré-Natal e Nascimento

Abstract

The formulation and implementation of policies directed to the humanization of obstetric and neonatal care demonstrate that there is an urgency and demand for factual interventions in this area. This thesis has as its object, the Program of Humanization in Prenatal and Birth (PHPN), instituted in 2000 by the Ministry of Health, which was the first specifically directed to the humanization of childbirth in Brazil, aiming to reduce maternal and child mortality and to ensure a welcoming quality service for women based on the assurance of citizenship rights. This is a qualitative research with a theoretical-critical character, bibliographic and documentary inserted in the evaluative research field, within the line of political evaluation of the policy. The objective is to evaluate the PHPN based on the political and socio-cultural assumptions that support it and considering the management of Brazil’s Unified Health System (SUS) and the context of health in Brazil in the period from 2000 to 2017. It highlights the matter related to the concept of humanization and childbirth humanization, Brazil’s Unified Health System management, neoliberalism, obstetric violence and technocracy. It quested to analyze the structuring of health in Brazil and the process of constructing the logic of childbirth and the structural and contextual determinants that led to the formulation of policies for the humanization of childbirth. PHPN engineering, its tenor and its objectives were evaluated in the view of Brazilian health neoliberal conjuncture. It was found that the PHPN puts the term humanization as the central focus of its proposal, but directs its actions towards technical protocols to be followed, which does not undo the technocratic model, nor does it promote assistance to prenatal care and humanized birth and does not favor the strengthening of women during the care process, since actions, initiatives and decision making remain under the responsability of health professionals.