Evaluation of the Maternal and Child Forum Strategy for Improving Childbirth and Postpartum Care and Reducing Maternal Morbidity and Mortality in São Paulo, Brazil

Maternal mortality remains a major public health problem and a sensitive indicator of living conditions, health system organization, and quality of care throughout the pregnancy–puerperium cycle. In the context of the Brazilian Unified Health System (Sistema Único de Saúde – SUS), strategies based on network articulation, continuing education, and institutional support have been essential to improve care and increase the preventability of maternal deaths and severe maternal morbidity events. Objective: To describe the organization and implementation process of the maternal and Child Forums and to analyze their contributions to strengthening network-based work and improving care for the pregnancy–puerperium cycle within the Unified Health System (SUS). Method: A qualitative, descriptive study using mixed methods, conducted retrospectively between 2019 and the first semester of 2023 in the RRAS 3 Health Region – Franco da Rocha, São Paulo State, Brazil. Data collection included interviews, observation of Forum meetings, questionnaires administered to managers and health professionals, as well as documentary analysis and health indicators. Qualitative data were analyzed using thematic content analysis. Results: The Maternal and Child Forums were established as an institutional support strategy capable of strengthening the maternal and child health care network, promoting care coordination, and improving work processes. The systematic use of indicators combined with collective discussion of care flows facilitated the identification of gaps, the agreement on responsibilities, and the adoption of organizational adjustments, with a positive impact on integration across different levels of care. Conclusion: The implementation of the Forums contributed to strengthening governance, comprehensiveness, and equity in care for the pregnancy–puerperium cycle, improving care and surveillance practices. The strategy shows potential for adaptation to other SUS contexts, provided that territorial specificities and institutional arrangements are taken into account.