The relationship between indicators of socioeconomic status and cesarean section in public hospitals

OBJECTIVE To assess the relationship between indicators of socioeconomic status and cesarean section in public hospitals that adopt standardized protocols of obstetrical care. METHODS This was a prospective cohort study conducted between May 2005 and January 2006 with 831 pregnant women recruited from 10 public primary care clinics in São Paulo, Brazil. Demographic and clinical characteristics were collected during pregnancy. The three main exposures were schooling, monthly family income per capita, and residential crowding. The main outcome was cesarean section at three public hospitals located in the area. Crude and adjusted risk ratios (RR), with 95% confidence intervals were calculated using Poisson regression with robust variance. We examined the effects of each exposure variable on cesarean section accounting for potential confounders by using four different models: crude, adjusted by mother’s characteristics, by obstetrical complications, and by the other two indicators of socioeconomic status. RESULTS Among the 757 deliveries performed in the public hospitals, 215 (28.4%) were by cesarean section. In the bivariate analysis, cesarean section was associated with higher family income per capita, higher education, lower residential crowding, pregnancy planning, white skin color, having a partner, and advanced maternal age. In the multivariate analysis, after adjustment for covariates, none of the socioeconomic status variables remained associated with cesarean section. CONCLUSIONS In this group, the chance of women undergoing cesarean section was not associated with indicators of socioeconomic status only, but was defined in accordance with major obstetric and clinical conditions

AS ORAÇÕES RELATIVAS NA VARIEDADE URBANA DO PORTUGUÊS DE MOÇAMBIQUE: UMA ABORDAGEM SOCIOLINGUÍSTICA

In this paper, we propose to describe the distribution of relativization strategies in the spoken variety of Mozambican Portuguese and the constraints that act on the implementation of non-standard relativizations in the oral modality of Mozambican Portuguese, in the light of the Theory of Variation and Change (WEINREICH; LABOV; HERZGOV, 2006[1968]). The data analyzed belongs to the main sample of the Corporaport project. As a research hypothesis, we assume that the varieties of Portuguese show “similar” tendencies in the productivity of relativization strategies, due to the generalization of “que” as a “universal” relative and the semantic emptying of prepositions, being the contact of Portuguese with the autochthonous languages of Mozambique a less relevant conditioning factor for the implementation of the non-standard relative. The results confirm the hypothesis since the informant’s level of education and syntactic-semantic constraints were relevant for the implementation of non-standard relativization strategies. The variables controlling for the effect of cross-language contact were not statistically relevant.Neste artigo, propõe-se descrever a distribuição das estratégias de relativização na modalidade oral da variedade moçambicana e os condicionamentos que atuam na implementação das relativas não padrão na modalidade oral do Português em Moçambique, à luz da Teoria da Variação e Mudança (WEINREICH; LABOV; HERZGOV, 2006[1968]). Os dados analisados pertencem à amostra principal do projeto Corporaport. Como hipótese de investigação, assume-se que as variedades do Português apresentam tendências “similares” na produtividade das estratégias de relativização, por conta da generalização do que como relativo “universal” e o esvaziamento semântico de preposições, sendo o contato do Português com as línguas autóctones de Moçambique um condicionamento pouco relevante para a implementação das relativas não padrão. Os resultados confirmam a hipótese, já que o nível de escolaridade do informante e condicionamentos sintático-semânticos foram relevantes para a implementação de estratégias de relativização não padrão.  As variáveis que controlam o efeito do contato entre línguas não foram relevantes estatisticamente

SOCIO-ECONOMIC AND OBSTETRIC PROFILE OF PUERPERAE ASSISTED IN A PHILANTHROPIC MATERNITY UNIT

Estudo descritivo, transversal, com abordagem quantitativa, cujo objetivo foi conhecer o perfil socioeconômico e obstétrico de puérperas assistidas em uma maternidade ao norte do Espírito Santo. Cerca de 54% das mulheres estavam na faixa etária de 20 a 29 anos, 83,6% eram casadas ou viviam com parceiro, 49,5% declararam-se pardas, 32,8% possuíam ensino médio completo, 49,8% tinham renda de até um salário mínimo, 61,6% pertenciam à classe C e 89,2% foram atendidas pelo Sistema Único de Saúde. Verificou-se que 72,4% tiveram de uma a duas gestações, 53,9% com intervalo interpartal de 2 a 5 anos, 62,2% com parto cesárea, cerca de 60% realizaram sete consultas ou mais de pré-natal e 87% negaram histórico de abortamento. Conclui-se que o perfil de puérperas é semelhante ao encontrado em outros estudos e evidencia-se a necessidade do serviço estar atento à não realização do pré-natal entre puérperas jovens e alta prevalência de parto cesárea. The aim of this descriptive, cross-sectional and qualitative study was to investigate the socio-economic and obstetric profile of puerperae assisted in a maternity unit in the North of Espírito Santo. Approximately 54% of the women were in the age range 20 to 29 years old, 83.6% were married or lived with a partner, 49.5% stated that they were of mixed race, 32.8% had finished junior high school, 49.8% had an income of not more than one minimum salary, 61.6% belong to social class C and 89.2% were attended by the Unified Health System (SUS). It was ascertained that 72.4% had had one to two pregnancies, 53.9% with an interpartal interval of 2 to 5 years, 62.2% with Caesarean section, approximately 60% had had seven or more pre-natal consultations and 87% denied having a history of miscarriage. It is concluded that the profile of puerperae is similar to that found in other studies and the need is evidenced for the service to be attent to the non-undertaking of pre-natal consultations among young puerperae and the high prevalence of Caesarean births.Estudio descriptivo, transversal, con abordaje cuantitativo, cuyo objetivo fue conocer el perfil socioeconómico y obstétrico de puérperas de una maternidad al norte de Espírito Santo. Aproximadamente 54% de las mujeres estaban en la franja etaria entre 20 y 29 años, 83,6% estaban casadas o vivían con pareja, 49,5% se declararon pardas, 32,8% completaron enseñanza media, 49,8% tenían renta de hasta un sueldo mínimo, 61,6% pertenecían a la clase C y 89,2% fueron atendidas por el Sistema Único de Salud. Se ha verificado que 72,4% tuvieron de una a dos gestaciones, 53,9% con intervalo interpartal de 2 a 5 años, 62,2% con parto cesárea, aproximadamente 60% realizaron siete consultas o más de prenatal y 87% negaron histórico de aborto. Se concluye que el perfil de puérperas es semejante a lo encontrado en otros estudios, evidenciándose la necesidad del servicio poner atención a la no realización del prenatal entre puérperas jóvenes y alta prevalencia de parto cesáreo

The relationship between indicators of socioeconomic status and cesarean section in public hospitals

ABSTRACT OBJECTIVE To assess the relationship between indicators of socioeconomic status and cesarean section in public hospitals that adopt standardized protocols of obstetrical care. METHODS This was a prospective cohort study conducted between May 2005 and January 2006 with 831 pregnant women recruited from 10 public primary care clinics in São Paulo, Brazil. Demographic and clinical characteristics were collected during pregnancy. The three main exposures were schooling, monthly family income per capita, and residential crowding. The main outcome was cesarean section at three public hospitals located in the area. Crude and adjusted risk ratios (RR), with 95% confidence intervals were calculated using Poisson regression with robust variance. We examined the effects of each exposure variable on cesarean section accounting for potential confounders by using four different models: crude, adjusted by mother’s characteristics, by obstetrical complications, and by the other two indicators of socioeconomic status. RESULTS Among the 757 deliveries performed in the public hospitals, 215 (28.4%) were by cesarean section. In the bivariate analysis, cesarean section was associated with higher family income per capita, higher education, lower residential crowding, pregnancy planning, white skin color, having a partner, and advanced maternal age. In the multivariate analysis, after adjustment for covariates, none of the socioeconomic status variables remained associated with cesarean section. CONCLUSIONS In this group, the chance of women undergoing cesarean section was not associated with indicators of socioeconomic status only, but was defined in accordance with major obstetric and clinical conditions

The relationship between indicators of socioeconomic status and cesarean section in public hospitals

ABSTRACT OBJECTIVE To assess the relationship between indicators of socioeconomic status and cesarean section in public hospitals that adopt standardized protocols of obstetrical care. METHODS This was a prospective cohort study conducted between May 2005 and January 2006 with 831 pregnant women recruited from 10 public primary care clinics in São Paulo, Brazil. Demographic and clinical characteristics were collected during pregnancy. The three main exposures were schooling, monthly family income per capita, and residential crowding. The main outcome was cesarean section at three public hospitals located in the area. Crude and adjusted risk ratios (RR), with 95% confidence intervals were calculated using Poisson regression with robust variance. We examined the effects of each exposure variable on cesarean section accounting for potential confounders by using four different models: crude, adjusted by mother’s characteristics, by obstetrical complications, and by the other two indicators of socioeconomic status. RESULTS Among the 757 deliveries performed in the public hospitals, 215 (28.4%) were by cesarean section. In the bivariate analysis, cesarean section was associated with higher family income per capita, higher education, lower residential crowding, pregnancy planning, white skin color, having a partner, and advanced maternal age. In the multivariate analysis, after adjustment for covariates, none of the socioeconomic status variables remained associated with cesarean section. CONCLUSIONS In this group, the chance of women undergoing cesarean section was not associated with indicators of socioeconomic status only, but was defined in accordance with major obstetric and clinical conditions

Conditional cash transfer programmes: the recent experience in Latin America and the Caribbean

Includes BibliographySpanish version available at the LibraryForeword Alicia BárcenaThis document summarizes experience with conditional cash transfer or "co-responsibility" (CCT) programmes in Latin America and the Caribbean, over a period lasting more than 15 years. During this time, CCTs have consolidated and spread through the region's various countries as a tool of choice for poverty-reduction policy. This document, which it is hoped will serve as a basis and input for discussion and progress in building social-protection systems premised on inclusion and universal rights, provides detailed information on the different components of CCTs. It also reviews their main characteristics in terms of the definition and registration of programme users, the targeting mechanisms used, the various types of benefits provided, and the conditionalities attached to them. It then analyses the historical trend of the indicators of CCT investment and coverage, and the information available 8 ECLAC on their effects in different domains. Lastly, it makes an assessment of the experience and the main challenges that these programmes pose in terms of their sustainability, legal framework, accountability, participation, institutionality and inter-sectoral characteristics