Evaluation of strategies, results and impact of the follow-up network for high-risk newborns (’Serenar’ Network) Córdoba, (Argentina), 1998-2003

Abstract

The development of follow-up networks for high-risk newborns is a goal of current policies of infant health care. Aim: to evaluate the Follow-up Services for High-risk Newborns of the Province of Córdoba. Materials and methods: Descriptive, retrospective health care services research. Analysis of said Program results. Strategic analysis of strengths, opportunities, weaknesses and threats. Impact indexes: age of first consultation for early auditory diagnosis; post-neonatal infant mortality. Results: A network of 550 service units belonging to various sectors participated in the study. A set of 11 Guidelines for Ambulatory Follow-up was published and High-risk Newborn Carnets were issued. A total of 2,000 professionals, technicians and parents received training. An Early Auditory Diagnosis Program was formulated. The following aspects were focused upon: weaknesses (disparity in the offer of specialists outside the capital city, dropouts for economic reasons), strengths (degree of professional involvement, continuity, multidisciplinary and participatory approach), threats (excess in the demand of services, low political priority of the network) and opportunities (participation of mutual health services, private health services, capability of services outside the capital city for organizing local programs). Impact as compared to the initial situation (1998): first consultation for Early Auditory Detection below 3 months of age, reduction of infant post-neonatal mortality due to neonatal or perinatal causes (60%). Conclusions: the interdisciplinary and inclusive approach as a basis for the interrelation strategy of the network has permitted the achievement of the goals of integral care for high-risk newborns and the decentralization of the follow-up services for the entire province. Positive Impacts were obtained: precocity of the first consultation for early auditory detection and reduction of post-neonatal infant mortality due to neonatal or perinatal causes.