The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005.

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  • Additional Information
    • Alternate Title:
      Impacto de los cambios en los indicadores de salud sobre las tasas de mortalidad infantil en Brasil, 2000 y 2005.
    • Subject Terms:
    • Author-Supplied Keywords:
      Brazil
      child health
      health investments
      health policy
      health status indicators
      Infant mortality
      Brasil
      indicadores de salud
      inversiones en salud
      Mortalidad infantil
      política de salud
      salud del niño
      Language of Keywords: English; Spanish
    • NAICS/Industry Codes:
      525120 Health and Welfare Funds
    • Abstract:
      Objectives. To investigate the associations between changes in indicators of health-related resources and coverage, and variations in infant mortality rates (IMR) in Brazil's 27 states in 2000 and 2005. Methods. Data were obtained from the Ministry of Health's online database, DATASUS. Stepwise multiple regressions were performed to model changes in IMR and its components (early, late, and post-neonatal mortality), using changes in the selected health indicators as predictors. Results. Regression analysis showed that improving access to prenatal care (B = -0.89 per 1 000; P < 0.001), increasing public expenditure on health as a proportion of gross domestic product (GDP) (B = -0.72 per 1 000; P = 0.031), and increasing access to the water supply (B = -0.22 per 1 000; P = 0.033) were associated with significant reductions in IMR. Declining early neonatal mortality rates were associated with prenatal care (B = -0.14 per 1 000; P = 0.026) and access to sanitation services (B = -0.05 per 1 000; P = 0.026). Reductions in late neonatal mortality rates were associated with prenatal care (B = -0.12 per 1 000; P = 0.003) and inversely correlated to the rate of cesarean deliveries (B = 0.13 per 1 000; P = 0.005). Post-neonatal mortality rate reductions were associated with prenatal care (B = -0.64 per 1 000; P < 0.001), increasing public expenditure on health as a proportion of GDP (B = -0.76 per 1 000; P = 0.005), and access to the water supply (B = -0.17 per 1 000; P = 0.037). Conclusions. Improving access to prenatal care, increasing public expenditure on health, and access to sanitation and water supply were all independently correlated to declining IMR; however, higher rates of cesarean deliveries were associated with higher late neonatal mortality rates. Continuous collection and analysis of relevant health indicators is recommended for developing evidence-based health policies and accurate predictions of how specific public health interventions might impact IMR. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Objetivos. Investigar las asociaciones entre los cambios en los indicadores de recursos y cobertura relacionados con la salud y las variaciones en las tasas de mortalidad infantil (TMI) en los 27 estados de Brasil entre los años 2000 y 2005. Métodos. Los datos se obtuvieron de la base de datos en línea del Ministerio de Salud, DATASUS. Mediante regresión múltiple paso a paso se modelaron los cambios en la TMI y sus componentes (mortalidades temprana, tardía y posneonatal), utilizando como predictores los cambios en indicadores seleccionados de salud. Resultados. Según el análisis de regresión, el mejoramiento del acceso a la atención prenatal (B = -0,89 por 1 000; P < 0,001) y al suministro de agua (B = -0,22 por 1 000; P = 0,033), y el aumento del gasto público en salud como proporción del producto interno bruto (PIB) (B = -0,72 por 1 000; P = 0,031) se asociaron con reducciones significativas de las TMI. Las reducciones de las tasas de mortalidad neonatal temprana se asociaron con la atención prenatal (B = -0,14 por 1 000; P = 0,026) y el acceso a servicios de saneamiento (B = -0,05 por 1 000; P = 0,026). Las reducciones en las tasas de mortalidad neonatal tardía se asociaron con la atención prenatal (B = -0,12 por 1 000; P = 0,003) e, inversamente, con la tasa de partos por cesárea (B = 0,13 por 1 000; P = 0,005). Las reducciones en las tasas de mortalidad posneonatal se asociaron con la atención prenatal (B = -0,64 por 1 000; P < 0,001), el aumento en el gasto público en salud como proporción del PIB (B = -0,76 por 1 000; P = 0,005) y el acceso a fuentes de agua (B = -0,17 por 1 000; P = 0,037). Conclusiones. El mejoramiento del acceso al cuidado prenatal, el incremento del gasto público en salud y el acceso al saneamiento y a fuentes de agua se correlacionaron independientemente con la reducción en las TMI; mayores tasas de partos por cesárea se asociaron con mayores tasas de mortalidad neonatal tardía. Se recomienda mantener la recolección y el análisis de los indicadores de salud relacionados con la TMI para desarrollar políticas de salud basadas en evidencias y elaborar predicciones precisas de cómo pueden intervenciones específicas en salud pública influir en las TMI. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Minas Gerais Hospital Foundation (FHEMIG), Belo Horizonte, Brazil
    • ISSN:
      1020-4989
    • Accession Number:
      10.1590/S1020-49892009001200002
    • Accession Number:
      48384141
  • Citations
    • ABNT:
      VOLPE, F. M. et al. The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005. Pan American Journal of Public Health, [s. l.], v. 26, n. 6, p. 478–484, 2009. DOI 10.1590/S1020-49892009001200002. Disponível em: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=48384141&authtype=sso&custid=s5834912. Acesso em: 25 jan. 2020.
    • AMA:
      Volpe FM, Abrantes MM, Capanema FD, Chaves JG. The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005. Pan American Journal of Public Health. 2009;26(6):478-484. doi:10.1590/S1020-49892009001200002.
    • APA:
      Volpe, F. M., Abrantes, M. M., Capanema, F. D., & Chaves, J. G. (2009). The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005. Pan American Journal of Public Health, 26(6), 478–484. https://doi.org/10.1590/S1020-49892009001200002
    • Chicago/Turabian: Author-Date:
      Volpe, Fernando M., Marcelo M. Abrantes, Flavio D. Capanema, and Josiano G. Chaves. 2009. “The Impact of Changing Health Indicators on Infant Mortality Rates in Brazil, 2000 and 2005.” Pan American Journal of Public Health 26 (6): 478–84. doi:10.1590/S1020-49892009001200002.
    • Harvard:
      Volpe, F. M. et al. (2009) ‘The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005’, Pan American Journal of Public Health, 26(6), pp. 478–484. doi: 10.1590/S1020-49892009001200002.
    • Harvard: Australian:
      Volpe, FM, Abrantes, MM, Capanema, FD & Chaves, JG 2009, ‘The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005’, Pan American Journal of Public Health, vol. 26, no. 6, pp. 478–484, viewed 25 January 2020, .
    • MLA:
      Volpe, Fernando M., et al. “The Impact of Changing Health Indicators on Infant Mortality Rates in Brazil, 2000 and 2005.” Pan American Journal of Public Health, vol. 26, no. 6, Dec. 2009, pp. 478–484. EBSCOhost, doi:10.1590/S1020-49892009001200002.
    • Chicago/Turabian: Humanities:
      Volpe, Fernando M., Marcelo M. Abrantes, Flavio D. Capanema, and Josiano G. Chaves. “The Impact of Changing Health Indicators on Infant Mortality Rates in Brazil, 2000 and 2005.” Pan American Journal of Public Health 26, no. 6 (December 2009): 478–84. doi:10.1590/S1020-49892009001200002.
    • Vancouver/ICMJE:
      Volpe FM, Abrantes MM, Capanema FD, Chaves JG. The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005. Pan American Journal of Public Health [Internet]. 2009 Dec [cited 2020 Jan 25];26(6):478–84. Available from: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=48384141&authtype=sso&custid=s5834912