Promoção da saúde materna e neonatal nos limites da vulnerabilidade

Student thesis: Doctoral Thesis


Facing the maternal and newborn mortality in the world, and namely in the underprivileged countries, is an imperative emphasized by the evidence that the causes are known and relatively simple to face, namely within the scope of the functions of nursing professionals. Maternal and Neonatal Mortality, on the one hand, and the state of development of countries and communities, on the other, are key indicators in the analysis and in the knowledge of people’s health levels, since their close interrelationship, nurtures and promotes the poverty situations which, in turn, create an obstacle to their own development. The United Nations and other international agencies with responsibility in addressing this situation, have developed, through the agenda of the Millennium Development Goals, - year 2000-, and the Goals for Sustainable Development, - year 2015-, an effort to parameterize the different interventions of States and Organizations, according to clear and interdependent objectives. Angola is a country in Southern Africa with very high rates of maternal and neonatal deaths, in such a way that its magnitude, made the efforts needed to find ways to overcome it, one of the national priorities, as defined by the Angolan state. The Centro Materno-Infantil Nª Srª da Graça, in Benguela, is a unit of the health centers network, of the Catholic Church of Angola and is located in a community of a peripheral neighborhood in Benguela, in a parish with approximately 140 000 inhabitants. For ten years, it has been carrying out important work to promote maternal and neonatal health, namely consultations on pregnancy surveillance, childbirth and postpartum support, pediatrics, gynecology and obstetrics, health promotion activities, in school and community settings. Since 2009, there have been an average of more than 800 births and 1900 prenatal consultations per year. Being considered as a reference center, in terms of the quality of health care, with reduced number of maternal and neonatal mortality, it was integrated into a project with international support, to strengthen the skills of nurses, midwives and managers, in health units of the Catholic Church in Benguela, Huambo and Bié, and of the Angolan state in the referred Provinces. Project Forvida - program “Obrigado Mãe” has supported the Center’s adjustment to the needs of the maternal and child health of a population that lives within the limits of vulnerability. Using a Case Study strategy, we have studied the Center, seeking to understand the reasons behind the reduced rate of Maternal and Neonatal mortality. The structural and procedural factors were explored, as well as the improvement actions carried out and the dynamics of permanent cooperation with Angolan and, national and international institutions. In the end, epidemiological results of Maternal and Neonatal Mortality of 133/100.000 and 9/1.000, respectively were obtained. These results are significantly lower than those accepted by international bodies, 477/100.000 (RMM) and 29/1.000 (NM), in 2018. From 2018 and due to methodological changes in the calculation of estimates, Angola started to present a value of 241/100,000 (MMR) (UI [167-346]) and 29/1,000 (NM). (1) It is concluded that the results are due to the compliance with the Quality Standards for this type of health units, defined by WHO, implemented in the management model and in the organization of nursing and medical professionals, of the Center, as well as in the permanent connection with the local community. It is considered demonstrated that it has been possible to reduce the indicators of Maternal and Neonatal Mortality in the Center, in a situation of social vulnerability, with few economic resources.
Date of Award23 May 2022
Original languagePortuguese
Awarding Institution
  • Universidade Católica Portuguesa
SupervisorMargarida Maria Vieira (Supervisor)


  • Maternal mortality
  • Neonatal mortality
  • Angola
  • Social vulnerability
  • Pregnancy


  • Doutoramento em Enfermagem

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