Barriers to access prenatal screening: integrative review

Abstract

Introduction: Prenatal monitoring is essential to reducing maternal and neonatal morbidity and mortality rates. However, organisational barriers may hamper access to the actions and services carrying on with the fragmentation and quality of care. Objectives: To analyse in the Brazilian scientific production the access barriers to performing screenings during prenatal monitoring. Methods: Integrative review of publications searched in the bibliographic databases of Latin American and Caribbean Center on Health Sciences Information (LILACS), Nursing Database (BDENF), and Medical Literature Analysis and Retrieval System Online (MEDLINE), published in Portuguese, English, and Spanish from 2005 to 2015. Results: Of 708 articles searched, 15 met the inclusion criteria. The studies were systematised and led to four categories for analysis: (1) Sluggishness in the process of exam scheduling, sample collection, and releasing of results; (2) Insufficient quotas for the primary care screenings; (3) Lack of resources of the pregnant women; and (4) Adequacy of screenings related to the early onset of prenatal care. Conclusions: The access barriers to screenings in the prenatal monitoring are mainly related to the scant health resources devoted to primary care; sluggishness in the process of scheduling and running of tests; and to the lack of resources of the pregnant woman, who cannot afford the costs of examinations not covered by the public health system. The publications also highlighted the positive aspects for the pregnant women who had an early onset of prenatal care.