Avaliação das açöes de controle da sífilis e do HIV na assistência pré-natal da rede pública do município do Rio de Janeiro, Brasil.

Objectives:to evaluate the adequacy of action taken to control syphilis and HIV in prenatal health care at Brazilian National Health System units in the municipality of Rio de Janeiro, Brazil. Methods: a cross-sectional study was carried out in 2007 and 2008, involving interviews with 2353 pregnant women, analysis ofprenatal cards and data obtained from 102 health professionals. A logicaloperational model was drawn up to evaluate the adequacy of care, taking as a point of reference the care protocols used for the Brazilian Ministry of Health `s prenatal care and STD/AIDS programs. Adequacy was deemed to be fulfillment of 100% of the activities envisaged for each gestational age. Results: shortcomings were identified in the counseling of pregnant women, the provision of serum tests, the treatment of cases of syphilis and the approach ofpartners. Bivariate analysis showed that starting prenatal care late and having an inadequate number of consultations lowered the adequacy of all actions, with the exception of HI V counseling. Conclusions: problems with early initiation of prenatal care, ensuring the minimum number of consultations, adequately managing pregnant women and their partners and, above all, appropriate serum test results for syphilis and HIV are obstacles to improved control of vertical transmission of these diseases. [ABSTRACT FROM AUTHOR]