227The use of cross-sectional series as a source of evidence for policymaker decision in Brazil

Abstract

Abstract Background To verify the effectiveness of public policies, two or more cross-sectional studies can be carried out in series. The objective of this work is to present the maternal and child health research of Ceará (PESMIC), Brazil, a series of cross-sectional studies carried out in a partnership between the university and the local government. Methods PESMIC is a series of cross-sectional studies with constant methodology, a sample obtained in multiple stages, with systematic and clusters sampling, state-wide representative, which visits 8000 households in 1987, 1990, 1994, 2001, 2007 and 2017. Around 300 variables are collected, in three different questionnaires, for the home, mothers, and children. Results PESMIC demonstrated over 30 years the improvement of several indicators such as the drop in infant mortality from 120 to 10 per thousand, the reduction of child malnutrition from 26.8% to 8.6%, the increase in infant breastfeeding for six months from 3% to 99%, the increase in maternal literacy from 58% to 97%. Conclusions Over 30 years, PESMIC presented results that allowed the evaluation of public policies and the occurrence of epidemiological transitions that occurred at the population level. The use of oral rehydration serum applied by community health workers, both unprecedented in Brazil when they started in Ceará, had their effectiveness demonstrated by PESMIC and were expanded to the rest of the country soon afterward. We conclude that the transversal series are studies that can help guide decision making by public health managers. Key messages The use of cross-sectional series can be a feasible alternative for the formation of evidence to aid decision-making The use of the PESMIC transversal series in Ceará helps Brazil in making important decisions such as the expansion of the community health workers program