Abstract
As newborns are highly vulnerable, they require essential care for adequate child development. This study aimed to assess the care provided to newborns during the first 28 days of life and identify factors associated with adequate care. This was a longitudinal study conducted with 415 mothers and full-term newborns from 4 public maternity hospitals in Natal, Brazil, in 2019. Assistance, socioeconomic, and demographic data were collected 3 times: 48 hours, 7 days, and 28 days after birth. Pearson's chi-square and Poisson regression tests were used with a confidence interval of 95%. Most mothers were between 20 and 29 years old (46.5%), had a high school or higher education (65.3%), a partner (79%), an income of ≤ 1 minimum wage (64, 6%), and were multiparous (62.9%). A total of 29 actions performed in maternity hospitals and 11 in primary healthcare were evaluated. Among the first, 8 (27.6%) were satisfactory; 11 (37.9%), partially satisfactory; and 10 (34.5%), unsatisfactory. In primary care, 2 actions (18.2%) were considered satisfactory; 3 (27.3%) partially satisfactory; and 6 (54.5%) unsatisfactory. In the multivariate analysis of the composite indicators related to adequacy of care, women undergoing vaginal delivery, those who are multiparous, and maternity hospitals at usual risk were associated with better adequacy of care indicators (P ≤ .05). Maternity hospitals accredited to the Baby-Friendly Hospital Initiative had lower chances of the adequacy of promotion to exclusive breastfeeding. The sample loss rate was 13.7% in the first week and 16.6% at the end of the study period. There was inadequacy in the performance of care actions for newborns regarding access and comprehensiveness of care. These weaknesses highlight the need for reassessing skills and coordinating actions in the child's healthcare network.