Strategic planning to strengthen care for high-risk pregnancy women in primary care: experience report

Abstract

Objective: To report the experience of developing and implementing a participatory action plan to ensure continued monitoring of high-risk pregnant women by a Family Health Strategy team in Porto Velho, Rondônia. Methods: This is a descriptive study, in the form of an experience report, developed by nursing students from the Federal University of Rondônia, working with a Family Health Strategy team. Situational strategic planning tools were used. Results: The results showed that the difficulty in continuing monitoring of pregnant women referred to high-risk services was the primary problem, related to inefficient communication between levels of care, a lack of understanding of the role of Primary Health Care, and a weak connection between users and the team. The main contributions were the collective agreement on strategies, such as intensifying weekly outreach, continuous scheduling at the Family Health Unit, and the creation of a monitoring spreadsheet, culminating in the team's realignment with its role as care coordinators. Conclusion: it is concluded that the use of situational strategic planning tools enhanced the team's protagonism, qualifying care and strengthening the role of Primary Health Care as a care coordinator, with recommendations for consolidating counter-referral flows and replicating the model in other contexts.