Determinants of infant mortality in the Jequitinhonha Valley and in the North and Northeast regions of Brazil
Open Access
- 1 January 2017
- journal article
- research article
- Published by FapUNIFESP (SciELO) in Revista de Saúde Pública
Abstract
OBJECTIVE This study aims to identify the social and demographic determinants, in addition to the determinants of reproductive health and use of health services, associated with infant mortality in small and medium-sized cities of the North, Northeast and Southeast regions of Brazil. METHODS This is a case-control study with 803 cases of death of children under one year and 1,969 live births (controls), whose mothers lived in the selected cities in 2008. The lists of the names of cases and controls were extracted from the Sistema de Informação sobre Mortalidade (SIM – Mortality Information System) and the Sistema de Informação sobre Nascidos Vivos (SINASC – Live Birth Information System) and supplemented by data obtained by the research of “active search of death and birth”. Data was collected in the household using a semi-structured questionnaire, and the analysis was carried out using multiple logistic regression. RESULTS The final model indicates that the following items are positively and significantly associated with infant mortality: family working in agriculture, mother having a history of fetal and infant losses, no prenatal or inadequate prenatal, and not being associated to the maternity hospital during the prenatal period. We have observed significant interactions to explain the occurrence of infant mortality between race and socioeconomic score and between high-risk pregnancy and pilgrimage for childbirth. CONCLUSIONS The excessive number of home deliveries and pilgrimage for childbirth indicates flaws in the line of maternity care and a lack of collaboration between the levels of outpatient and hospital care. The study reinforces the need for an integrated management of the health care networks, leveraging the capabilities of cities in meeting the needs of pregnancy, delivery and birth with quality.Keywords
This publication has 15 references indexed in Scilit:
- Pesquisa Nascer no Brasil: perfil da mortalidade neonatal e avaliação da assistência à gestante e ao recém-nascidoCadernos de Saude Publica, 2014
- Determinantes da mortalidade neonatal: estudo caso-controle em Fortaleza, Ceará, BrasilCadernos de Saude Publica, 2012
- Mortalidade infantil e acesso geográfico ao parto nos municípios brasileirosRevista de Saúde Pública, 2012
- Análise da distribuição espacial da mortalidade neonatal e de fatores associados, em Salvador, Bahia, Brasil, no período 2000-2006Cadernos de Saude Publica, 2011
- Desigualdades sócio-espaciais da adequação das informações de nascimentos e óbitos do Ministério da Saúde, Brasil, 2000-2002Cadernos de Saude Publica, 2007
- Avaliação da peregrinação anteparto numa amostra de puérperas no Município do Rio de Janeiro, Brasil, 1999/2001Cadernos de Saude Publica, 2006
- Atenção à saúde e mortalidade neonatal: estudo caso-controle realizado em Campinas, SPRevista Brasileira de Epidemiologia, 2004
- Uso do índice de Kotelchuck modificado na avaliação da assistência pré-natal e sua relação com as características maternas e o peso do recém-nascido no Município do Rio de JaneiroCadernos de Saude Publica, 2004
- Mortalidade neonatal no Município de São Paulo: influência do peso ao nascer e de fatores sócio-demográficos e assistenciaisRevista Brasileira de Epidemiologia, 2002
- An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index.American Journal of Public Health, 1994