Universidade Federal do Rio Grande do Norte, João Pessoa, Brazil.
Nurs Inq. 2011 Mar;18(1):84-91. doi: 10.1111/j.1440-1800.2011.00520.x.
The Kangaroo Program, originally developed in Colombia, was adopted as a public policy by the Brazilian Unified Health System (SUS) in 2000, in an effort to improve maternal and infant health in the country. This article aims to examine the Kangaroo Program as it is practiced and carried out at a maternity hospital in the northeastern Brazilian region. Through an institutional ethnographic approach, research demonstrates that the Kangaroo Program has been effective in saving lives and improving some of the infants' health outcomes. However, research also demonstrates that: (i) the socioeconomic profile of mothers in the Kangaroo Program, (ii) conflicting relationships between healthcare workers and users, and (iii) lack of socioeconomic and emotional support are impairing the adequate implementation of the program. Due to the low literacy level of most of these mothers, institutional power is used as a form of social control to keep mothers uninformed about the possibility of leaving the maternity wards. In a two-tier health system, this controlling behavior is part of existing social inequities, as the Kangaroo Program is a choice in the private health system but tends to be mandatory at SUS maternity hospitals across Brazil.
袋鼠式护理方案最初在哥伦比亚开发，于 2000 年被巴西统一卫生系统（SUS）采纳为公共政策，旨在改善该国母婴健康。本文旨在考察巴西东北部地区一家妇产医院实施的袋鼠式护理方案。通过机构民族志方法，研究表明袋鼠式护理方案在拯救生命和改善一些婴儿健康结果方面是有效的。然而，研究还表明：（i）参与袋鼠式护理方案的母亲的社会经济状况，（ii）医护人员与使用者之间的冲突关系，以及（iii）缺乏社会经济和情感支持，正在阻碍该方案的充分实施。由于这些母亲的大多数文化水平较低，机构权力被用作一种社会控制形式，使母亲无法了解离开妇产科病房的可能性。在两级卫生系统中，这种控制行为是现有社会不平等的一部分，因为袋鼠式护理方案是私人卫生系统的一种选择，但在巴西的 SUS 妇产医院往往是强制性的。
