Table 1 Magnesium sulfate in preeclampsia/eclampsia in public health system in the municipality of Campinas, SP - Brazil
Component | Facilitator | Barriers |
|---|---|---|
Regulatory | ||
Legislation | ✓ Healthcare Pact of 2006 - administrative rule n° 399/MH | ✓ Application of MgSO4 is made only in hospitals ✓ Level for application of MgSO4 is not available |
✓ Stork Network of 2011 – Administrative rule n° 1459/ MH | ||
✓ MgSO4 20 and 50 % is included in the basic and essential list of drugs for hospital units | ||
✓ Urgency/ Emergency Network - Administrative rule n° 1600/ MH | ||
✓ Prioritizes trauma, cardiovascular and cerebrovascular care | ||
Registration | ✓ RENAME – MH and SDH-SP: has MgSO4, | ✓ No specification for use in hypertensive syndromes |
✓ Drug registration - ANVISA | ||
✓ Municipal list: no reference to MgSO4 | ||
Protocol | ✓ Urgency/emergency protocol /2000 - MH | ✓ Municipal Protocol: lacking |
✓ Level for application of MgSO4 is not available | ||
✓ High-risk pregnancy protocol /2012 – MH | ||
✓ No specification for use in hypertensive disorders | ||
✓ SDH-SP protocol / PN and Puerperal Technical Manual 2010 | ||
✓ Basic Life Support (BLS) and Advanced Life Support (ALS) / MH | ||
✓ EMCS municipal protocol /guidance of patient transportation in cases of pregnancy-related hypertension | ||
Drug | ||
Conditions of applicability | ✓ All | ✓ PHU: only essential equipment |
Availability | ✓ Presence UC/ ER and Maternity Hospitals | ✓ Lacking PHU and EMCS |
Structure | ||
Equipment | ✓ Available at UC, EMCS and Maternity Hospitals | ✓ PHU: only essential equipment |
Physical | ✓ Distribution apparently adequate for HCN | |
✓ PHU with medication room adapted to local architecture | ||
✓ UC, EMCS and Maternity Hospital with adequate architecture | ||
Organizational | ✓ Presence of physicians | ✓ PHU: destined to ambulatory scheduling |
✓ Insufficient number of physicians for urgencies in PHU | ||
✓ Exclusion of UC/ER in the care of pregnant women | ||
✓ Protocol lacking in UC/ER, available in 56 % of PHU, present in the maternity hospitals | ||
✓ Exclusive use by the obstetrician | ||
✓ Responsibility not established | ||
✓ Elective work activity (programmed schedule) | ||
✓ Lack of training | ||