En este documento se presenta una política para orientar y brindar apoyo a los Estados Miembros de la Organización Panamericana de la Salud (OPS), así como a la Oficina Sanitaria Panamericana, en las actividades de cooperación técnica dirigidas a mejorar la salud mental como prioridad para fome...ntar el desarrollo social, económico y de salud en la Región en el contexto de la pandemia de COVID-19 y posteriormente.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Para isso, propõe-se utilizar como marco de referência a pirâmide de intervenções para os serviços de SMAPS do Comitê Permanente Interagências (IASC). A pirâmide ilustra diferentes níveis de apoio que variam desde a integração de considerações sociais, de segurança e relativas às nec...essidades básicas, até a prestação de serviços especializados para o manejo de condições mais graves, assim como a provável dimensão de demanda para cada um dos níveis estabelecidos.
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