Infant mortality and geographic access to childbirth in Brazilian municipalities.

Abstract:

OBJECTIVE:To analyze geographic access to hospital childbirth in Brazilian municipalities. METHODS:Information on deaths and births were analyzed in regards to appropriateness for calculating the infant mortality rate during the period 2005 to 2007, for the 5,564 Brazilian municipalities. Indicators of supply and geographic access to health services were calculated to express hospital childbirth access. A multivariate regression model was used to test the association between geographic access to childbirth and the infant mortality rate in municipalities with adequate vital information. RESULTS:Of the municipalities analyzed, 56% had adequate vital information, corresponding to 72% of Brazil's population. The geographic distance between the municipality of residence and municipality of hospitalization was inversely associated to population size, per capita income and the infant mortality rate, even when controlling for demographic and socioeconomic factors. CONCLUSIONS:Although important strategies have been developed in Brazil to improve the quality of care for pregnant women, actions to guarantee equal access to childbirth services are still insufficient. Large geographic distance to childbirth facility was identified as a risk factor for infant mortality, together with unequal supply of quality health services and lack of integration with primary care.

journal_name

Rev Saude Publica

journal_title

Revista de saude publica

authors

Almeida Wda S,Szwarcwald CL

doi

10.1590/s0034-89102012005000003

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

68-76

issue

1

eissn

0034-8910

issn

1518-8787

pii

S0034-89102012005000003

journal_volume

46

pub_type

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