{"id":4051,"date":"2015-10-08T16:28:31","date_gmt":"2015-10-08T19:28:31","guid":{"rendered":"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/?p=4051"},"modified":"2015-10-14T14:23:35","modified_gmt":"2015-10-14T17:23:35","slug":"the-controversial-reorganization-of-perinatal-services-in-portugal","status":"publish","type":"post","link":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/the-controversial-reorganization-of-perinatal-services-in-portugal\/","title":{"rendered":"The controversial reorganization of perinatal services in Portugal"},"content":{"rendered":"<p style=\"text-align: right;\">8 October, 2015<\/p>\n<div id=\"attachment_4072\" style=\"width: 310px\" class=\"wp-caption alignright\"><a href=\"http:\/\/www.scielo.br\/pdf\/sausoc\/v20n3\/07.pdf\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4072\" class=\"size-medium wp-image-4072  \" alt=\"Screen Shot 2015-10-08 at 4.10.17 PM\" src=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/wp-content\/uploads\/2015\/10\/Screen-Shot-2015-10-08-at-4.10.17-PM-300x253.png\" width=\"300\" height=\"253\" srcset=\"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-content\/uploads\/2015\/10\/Screen-Shot-2015-10-08-at-4.10.17-PM-300x253.png 300w, https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-content\/uploads\/2015\/10\/Screen-Shot-2015-10-08-at-4.10.17-PM.png 346w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-4072\" class=\"wp-caption-text\">Pictures published in the national press. Source: article by Ana Raquel Matos http:\/\/www.scielo.br\/pdf\/sausoc\/v20n3\/07.pdf<\/p><\/div>\n<p>in the article\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702015000300705&amp;lng=pt&amp;nrm=iso&amp;tlng=en\">The controversy over the restructuring of perinatal emergency services in Portugal<\/a>, Ana Raquel Matos,\u00a0researcher at the University of Coimbra explores the controversial decision made by the Ministry of Health which resulted in the closure of several maternity wards in 2006.<\/p>\n<p>The researcher also\u00a0explores\u00a0the protests held across the country against these measures, with particular emphasis to\u00a0the importance of citizen participation in the formulation of health policies.<\/p>\n<p>In order to study this case, Ana Raquel used interviews with key informants, \u00a0documents, reports and articles selected from the Di\u00e1rio de Not\u00edcias, Jornal de Not\u00edcias, and Expresso newspapers.<\/p>\n<p><strong>Maternal and child health policies in Portugal before and after 2006 &#8211; a brief overview<\/strong><\/p>\n<p>It was only in the 1970s\u00a0\u00a0that the Portuguese government acknowledged responsibility for health policy and took \u00a0important actions which included universal access to healthcare and investment in primary care.<\/p>\n<p>After 1989, attempts were made to create larger maternity units based on the assumption that the quality of services depended on the number of deliveries performed at the facility each year.<\/p>\n<p>In 2006 a group of experts wrote a report\u00a0reiterating the recommendations regarding concentration of births in larger health units. Some days later\u00a0the minister signed a directive providing for the closure of maternity wards which performed less than 1,500 births per year.<\/p>\n<p><strong>The protests<\/strong><\/p>\n<p>Criticism and suspicion of the measures were voiced soon after the ministerial decision in 2006.\u00a0According to some interviews, the controversy arose mainly due the lack of public participation in the decision-making process.<\/p>\n<div id=\"attachment_4075\" style=\"width: 310px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/www.scielo.br\/pdf\/sausoc\/v20n3\/07.pdf\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4075\" class=\"size-medium wp-image-4075  \" style=\"margin: 5px;\" alt=\"Screen Shot 2015-10-08 at 4.24.51 PM\" src=\"http:\/\/www.revistahcsm.coc.fiocruz.br\/english\/wp-content\/uploads\/2015\/10\/Screen-Shot-2015-10-08-at-4.24.51-PM-300x201.png\" width=\"300\" height=\"201\" srcset=\"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-content\/uploads\/2015\/10\/Screen-Shot-2015-10-08-at-4.24.51-PM-300x201.png 300w, https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-content\/uploads\/2015\/10\/Screen-Shot-2015-10-08-at-4.24.51-PM.png 394w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-4075\" class=\"wp-caption-text\">Outdoor in one of the towns where the protests were held. Source: article by Ana Raquel Matos. http:\/\/www.scielo.br\/pdf\/sausoc\/v20n3\/07.pdf<\/p><\/div>\n<p>Those who felt affected by the decision to close the wards claimed that there was no room for dialogue. Most of the actors against the resolution felt that they were given no opportunity to engage in dialogue with the decision-makers and present their arguments.<\/p>\n<p>During the 2006 and 2007 protests, opponents of the measure objected to the adoption of \u201cpurely economic criteria,\u201d accusing the government of using \u201cterror tactics\u201d and emphasizing that the arguments against closure outweighed those in favor. \u00a0Another issue at stake was the lack of transparency and consultation during the decision-making process.<\/p>\n<p><strong>\u00a0Conclusions<\/strong><\/p>\n<p>The article concludes that the Portuguese government neglected the protests and decided to close \u00a0maternity wards without informing or consulting the respective local authorities and populations.<\/p>\n<p>It states that policy makers do not \u201cgive due weight\u201d to protests as a valid form of participation in decision-making processes. Although the protests were generally unsuccessful, they led the government to consider the problems raised and make certain modifications.<\/p>\n<p>Read the full article:<\/p>\n<p>Matos, Ana Raquel.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702015000300705&amp;lng=en&amp;nrm=iso\"><span>The controversy over the restructuring of perinatal emergency services in Portugal and the importance of citizen participation in health care decision-making processes<\/span><\/a>.\u00a0<i>Hist. cienc. saude-Manguinhos<\/i>, Sept 2015, vol.22, no.3, p.705-722. ISSN 0104-5970<\/p>\n<p>Related articles already published in HCS-Manguinhos:<\/p>\n<p>Biernat, Carolina and Ramacciotti, Karina\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702011000500009&amp;lng=en&amp;nrm=iso\">La protecci\u00f3n a la maternidad de las trabajadoras en Argentina:\u00a0aspectos legales y administrativos en la primera mitad del siglo XX<\/a>.\u00a0<i>Hist. cienc. saude-Manguinhos<\/i>, Dic 2011, vol.18, suppl.1, p.153-177. ISSN 0104-5970<\/p>\n<p>Castej\u00f3n, Ram\u00f3n, Perdiguero, Enrique and Ballester, Rosa.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702002000400010&amp;lng=en&amp;nrm=iso\">Los medios de comunicaci\u00f3n al servicio de la lucha antiven\u00e9rea y la protecci\u00f3n de la salud materno-infantil (1900-50).\u00a0<\/a><i>Hist. cienc. saude-Manguinhos<\/i>, Jun 2006, vol.13, no.2, p.411-437. ISSN 0104-5970<\/p>\n<p>Di Liscia, Mar\u00eda Silvia.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702002000400010&amp;lng=en&amp;nrm=iso\">Hijos sanos y leg\u00edtimos:\u00a0sobre matrimonio y asistencia social en Argentina (1935-1948).<\/a>\u00a0<i>Hist. cienc. saude-Manguinhos<\/i>, 2002, vol.9, p.209-232. ISSN 0104-5970<\/p>\n<p>Franzoni, Juliana Mart\u00ednez.\u00a0<a href=\"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&amp;pid=S0104-59702006000300004&amp;lng=en&amp;nrm=iso\">\u00bfPresi\u00f3n o legitimaci\u00f3n? Poder y alternativas en el dise\u00f1o y adopci\u00f3n de la reforma de salud en Costa Rica, 1988-1998<\/a>.\u00a0<i>Hist. cienc. saude-Manguinhos<\/i>, Set 2006, vol.13, no.3, p.591-622. ISSN 0104-5970<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Article explores the protests against the decision that resulted in the closure of several maternity wards in 2006 and discusses the importance of citizen participation in the formulation of health policies.<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"footnotes":""},"categories":[4],"tags":[434,205,428],"class_list":["post-4051","post","type-post","status-publish","format-standard","hentry","category-highlights","tag-ana-raquel-matos","tag-hcs-m","tag-portugal"],"_links":{"self":[{"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/posts\/4051","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/comments?post=4051"}],"version-history":[{"count":11,"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/posts\/4051\/revisions"}],"predecessor-version":[{"id":4078,"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/posts\/4051\/revisions\/4078"}],"wp:attachment":[{"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/media?parent=4051"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/categories?post=4051"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistahcsm.coc.fiocruz.br\/english\/wp-json\/wp\/v2\/tags?post=4051"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}