Interventii la primul eveniment regional de informare si dezvoltare a Retelei RENASC

RENASC – REțea NAțională de promovare a Sănătății reproduCerii prin politici publice integrate”

“Sanatatea este comoara cea mai de pret, dar pe care o poti pierde atat de usor” Daniela Vlasceanu (reprezentant UNICEF)

Acesta a fost unul din punctele de plecare ale evenimentului de lansare a proiectului ”RENASC – REțea NAțională de promovare a Sănătății reproduCerii prin politici publice integrate”, organizat de Institutul Național pentru Sănătatea Mamei și Copilului „Alessandrescu-Rusescu” in colaborare cu Asociația PartNET – Parteneriat Pentru Dezvoltare Durabilă, Asociația SAMAS si Asociația Moașelor Independente, desfasurat in data de 19 decembrie 2018, in incinta Hotelului Ibis din Bucuresti.

Evenimentul este primul din seria celor 8 organizate de Institutul Național pentru Sănătatea Mamei și Copilului „Alessandrescu-Rusescu” sub atenta coordonare a dl-ui Prof dr. Matei Dumitru, si a doamnei Cercetator Stiintific Dr. Nanu Michaela, in vederea definirii structurii organizatorice si functionale a Retelei Tematice Nationale RENASC – Reteaua Nationala pentru Sanatatea Reproduceri. Acesta are rolul de a aduce impreuna actorii relevanti in domeniu, cercetatori, medici specialisti in domeniul sanatatii reproducerii, ONG-uri, membrii ai comunitatii academice si social media, interesati de imbunatatirea politicilor in vigoare cu privire la sanatatea reproducerii.

Proiectul urmărește constituirea unei rețele naționale din actori relevanți în domeniu sănătății reproducerii care vor analiza politicile de sănătate și sociale existente în domeniu și vor transmite soluții/propuneri de îmbunătățire a prevederilor legislative, astfel încât femeile si copiii să aibă acces nelimitat și egal la servicii medicale de înaltă calitate.

Proiectul abordeaza problemele centrale identificate, respectiv necesitatea crearii unui parteneriat public-privat cu scopul de a monitoriza sistuatia si efectele concrete ale politicilor publice din domeniul sanatatii reproducerii, de a elabora impreuna propuneri alternative la politicile in vigoare, in vederea rezolvarii problemelor existe (declinul demografic si rata ridicata a mortalitatii materne si infantile din Romania), de a crea un parteneriat sustenabil in acest domeniu.

RETEAUA este conceputa in vederea monitorizarii si evaluarii politicilor publice existente in domeniul sanatatii reproducerii, incluzand asistenta medicala preconceptionala, prenatala a femeilor cu varsta fertila etc.

Printre problemele  deosebit de importante discutate si prezente pe agenda interventiilor, se numara:

  • Sarcina la minore, operatiile de cezariana (numarul lor este in crestere);
  • Promovarea educatiei Sanatatii Reproducerii in institutii de invatamant;
  • Editarea si distribuirea in randul populatiei a materialelor informative in domeniul sanatatii reproducerii;
  • Planificare familiala;
  • Sanatatea reproductiva la adolescenti;
  • Avortul, consultatiile prenatale;
  • Statutul moaşei în sistemul medical românesc si decizia politică în definirea statutului moaşei;
  • Sistemul de comunicare – carnetul gravidei,
  • Asigurarea accesului populatiei prin integrarea serviciilor de sanatate a reproducerii in asistenta medicala primara
  • Asigurarea condiţiilor necesare unei naşteri sigure şi un cadru în care femeia să fie informată;
  • Prevenirea si managmentul violentei in familie

 

Lista ramane deschisa. Expertii prezenti la eveniment au subliniat faptul ca nu se discuta in societate cu adevarat despre aceste probleme, despre evaluarea calitatii serviciilor prenatale – cu accent pe programele care urmaresc gravida in perioada prenatala, programe care, in societatea romaneasca pur si simplu nu exista; despre mediul toxic care influenteaza sarcina dar si despre faptul ca oamenii nu sunt interesati de informare prenatala, in conditiile in care abia isi pot asigura traiul zilnic.

Din cadrul Institutului Național pentru Sănătatea Mamei și Copilului „Alessandrescu-Rusescu” d-na CS I Dr. Stativa Ecaterina a prezentat un scurt material despre evaluarea serviciilor prenatale. „Una dintre metodele de evaluare a serviciilor prenatale este prin combinarea a 2 indicatori:  primul este atunci cand are loc prima consultatie prenatala si cel de-al doi-lea – cate vizite prenatale face femeia. Pentru sarcina cu risc, in Romania sunt prevazute 8 vizite prenatale. Clasificarea arata ca 80% din totalul de vizite prevazut in tara de origine a gravidei (minim 6 vizite din 8), reprezinta ingrijire adecvata iar ce este sub acest procent, constituie ingrijiri neadecvate. Ultima evaluare pe care am facut-o pe acest subiect, a fost pe un esantion de 914 femei, din 2010, unde femeile care nu au beneficiat de consultatii prenatale au fost in procent de aproximativ 8%, insa situatia nu s-a imbunatatit prea mult nici in 2016. Ultimele studii realizate la nivel national, denota ca indicele de utilizare a constultatiilor prenatale in Romania, este curtremurator, intrucat doar 20% dintre femei au avut aceste ingrijiri adecvate. Celelalte sunt in acea zona de nesatisfacator, pentru ca nu au acele consultatii minime, ceea ce trimite Romania pe ultimul loc in Uniunea Europeana”.

„Cu referite la evaluarea calitatii ingrijirilor, exista o alta metodologie de supraveghere medicala activa a gravidelor care pune foarte mult accent pe realizarea investigatiilor prevazute in perioada prenatala si pe sistemul de comunicare/supraveghere efectuata in echipa: medic de familie(MF), specialist obstetician-ginecolog, medici de alte specialitati (in functie de patologia de care sufera femeia insarcinata).  Rezultatul acestei cooperari se materializdeaza cu centralizarea datelor despre gravide si se consemneaza in “Carnetul gravidei”. Aceasta comunicare inter-institutionala in beneficiul gravidei, in Romania, lipseste cu desavarsire” relateaza dna CS I Dr. Stativa Ecaterina.

Sunt probleme de subzistenta, ca lipsa alimentatiei si violenta domestica. Sunt probleme in a identifica si a folosi mecanismele de a ajunge la grupurile vulnerabile, unde ideea de informare prenatala si etapele premergatoare unei sarcini nici nu pot fi posibile. (Daniela Valceanu – reprezentant UNICEF Romania).

In aceste evaluari, expertii spun ca toate lucrurile pe care femeile le ignora, consultatiile, faptul ca sunt foarte multe femei care nu beneficiaza de ingrijiri adecvate, conduc la multe inegalitati in sanatate. Responsabilitatea pentru aceste inegalitati nu o poarta doar sistemul medical, se pune problema conditiilor precare in care traiesc unele femei in Romania. „Daca nu ne raportam la conditiile concrete in care traiesc aceste femei, noi nu ne putem imagina viata lor reala, traiesc doar intr-o singura camera, mediu in care se fumeaza, exista violenta domestica, consum de alcool si saracie. In aceste conditii nu te poti astepta ca oamenii sa investeasca in acte de preventie.”

„Acest proiect reprezinta o oportunitate deosebita pentru noi, ca experti in domeniu, ne permite sa utilizam integrat si eficient anii de experienta si cunostintele avansate pentru a beneficia pe termen lung , in a identifica probleme de natura celor discutate si a pune pe masa o politica publica coerenta, prin care sa actionam unit pentru un interes national. Iar daca autoritatile locale, nu se vor implica sa imbunatateasca cat de cat vietile acestor oameni, ei nu pot fi interesati de preventie,  in conditiile in care, aceste familii, nu au ce sa ofere copiilor de mancare.”

Multumim participantilor prezenti, membrilor echipei de implementare a proiectului si expertilor in domeniul sanatatii reproducerii, pentru prezentarea situatiei serviciilor prenatale si datelor la nivelul mortalitatii  infantile in Romania.

Precizam ca d-voastra sunteti stalpul de rezistenta si de cratie al acestei Retele, iar acest proiect constituie o oportunitate de interventie pentru toti actorii ce pot contribui la imbunatatirea starii de sanatate. Importante vor fi solutiile si materializarea lor.

Proiectul va avea acoperire națională şi se va implementa în perioada 27.06.2018 – 26.10.2019, având o durată de 16 luni, si este cofinantat din Fondul Social European prin Programul Operational Capacitate Administrativa 2014 – 2020.

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