Resumen
Sin duda, se han logrado grandes avances en materia de morbimortalidad materno-infantil. Sin embargo, la calidad de la atención en las instituciones de seguridad social es cuestionable, tal como lo reflejan las proporciones de nacimientos mediante cesárea al triple de lo recomendado por la OMS, el abandono en la lactancia materna y el hecho que hasta una de cada tres mujeres es víctima de maltrato durante la atención. Ante esto, el IMSS ha decidido implementar el modelo denominado Atención Materna Integral AMIIMSS, centrado en las personas usuarias y con sustento en la atención obstétrica amigable, que abarca distintas etapas. Cuatro pilares sustentan al modelo: empoderamiento de la mujer, adaptación de la infraestructura, capacitación y adecuación de procesos y normas. Si bien hay avances, con 73 salas de prelabor habilitadas y 14,103 atenciones amigables otorgadas, hay retos y desafíos por vencer.
En materia de empoderamiento, falta incluir el plan de parto como una práctica institucional. En cuanto a adecuación de infraestructura, se requiere presupuesto para construir y adecuar espacios amigables. Además, es necesaria la actualización de las plantillas de personal e inclusión de nuevas categorías para una adecuada operación del programa. Sobre capacitación, está pendiente la adecuación de planes formativos de médicos y enfermeras. En materia de procesos y normatividad, falta evaluación cualitativa del impacto sobre la experiencia y la satisfacción de las personas y la eliminación de la violencia obstétrica.
Abstract
Undoubtedly, great advances have been made in terms of maternal and infant morbidity and mortality. However, in Mexican Social Security System, the quality of maternal care is questionable, as reflected in proportions of cesarean births three times higher than those recommended by WHO, abandonment of exclusive breastfeeding and the fact that up to one in three women is a victim of abuse during delivery. Given this, the IMSS decides to implement the model called Integral Maternal Care AMIIMSS, focused on users experience and based on friendly obstetric care, along different stages of the reproductive process. Four pillars underpin the model, women’s empowerment, infrastructure adaptation, training and adaptation of processes and standards. Although there are advances, with 73 pre-labor rooms enabled and 14,103 friendly attentions granted, there are pending tasks and challenges.
In terms of empowerment, the birth plan needs to be included as an institutional practice. In terms of infrastructure adequacy, a budget is required to build and adapt friendly spaces. In addition, it is necessary to update the staffing tables and include new categories, for an adequate operation of the program. On training, the adaptation of academic plans for doctors and nurses is pending. In terms of processes and regulations, there is a lack of qualitative evaluation of the impact of the program on people’s experience and satisfaction and elimination of obstetric violence.
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