Secular trends in infant mortality by age-group and avoidable components in the State of São Paulo, 1996–2012

Kelsy Catherina Nema Areco,Tulio Konstantyner,José Augusto De Aguiar Carrazedo Taddei

doi:10.1016/j.rppede.2016.03.009

Kelsy Catherina Nema Areco, Tulio Konstantyner + Show 1 more

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https://doi.org/10.1016/j.rppede.2016.03.009

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Abstract

ObjectiveTo describe trends and composition of infant mortality rate in the State of São Paulo, from 1996 to 2012. MethodsAn ecological study was conducted, based on official secondary data of births and infant deaths of residents in São Paulo, from 1996 to 2012. The infant mortality rate was calculated by the direct method and was analyzed by graphs and polynomial regression models for age groups (early neonatal, late neonatal and post-neonatal) and for groups of avoidable causes of death. ResultsThe mortality rate in the State of São Paulo tended to fall, ranging from 22.5 to 11.5 per thousand live births. Half of the infant deaths occurred in the early neonatal group. The proportion of avoidable infant deaths varied from 76.0 to 68.7%. The deaths which were avoidable by adequate attention to women during pregnancy and childbirth and newborn care accounted for 54% of infant deaths throughout the period. ConclusionsThe mortality rate levels are still far from those in developed countries, which highlight the need to prioritize access and quality of healthcare services during pregnancy, childbirth and newborn care, especially in the first week of life, aiming at achieving standards of infant mortality similar to those of developed societies.

Highlights

Infant mortality rate (IMR) reflects the living and health conditions of populations, estimates the risk of death among children under one year old, and expresses the inequities in different parts of the world, as can be seen in Africa and Europe, whose IMR in 2013 were 60 and 11 per 1000 live births (‰ LB), respectively.1---4Reducing child mortality is one of the goals of the ‘‘eight Millennium Development Goals (MDGs)’’ established by the United Nations (UN) and agreed by Brazil, along with 190 nations in 2000
From 1996 to 2012, 10,827,106 live births and 168,187 infant deaths were recorded, children of mothers living in the State of São Paulo, and 99.8% of deaths occurred within the state itself (Fig. 1)
The early neonatal IMR ranged from 11.7‰ to 5.7‰ LB, down 51.3%; late neonatal ranged from 3.1‰ to 2.2‰ LB, down 28.2%; and post-neonatal ranged from 7.7‰ to 3.6‰ LB, down 52.9%

Summary

Introduction

Infant mortality rate (IMR) reflects the living and health conditions of populations, estimates the risk of death among children under one year old, and expresses the inequities in different parts of the world, as can be seen in Africa and Europe, whose IMR in 2013 were 60 and 11 per 1000 live births (‰ LB), respectively.1---4Reducing child mortality is one of the goals of the ‘‘eight Millennium Development Goals (MDGs)’’ established by the United Nations (UN) and agreed by Brazil, along with 190 nations in 2000. Infant mortality rate (IMR) reflects the living and health conditions of populations, estimates the risk of death among children under one year old, and expresses the inequities in different parts of the world, as can be seen in Africa and Europe, whose IMR in 2013 were 60 and 11 per 1000 live births (‰ LB), respectively.1---4. The Brazilian goal (IMR 15.7‰ LB by 2015) has already been met in 2011 (IMR 15.3‰ LB).[3,5] due to its territorial extent the country has a large variability in IMR and difficulty in producing accurate estimates of this indicator.[6,7] The highest IMR are in the North and Northeast and the lowest in the South and Southeast.[5,7] For example, in 2008---2010, the IMR corrected by active search of vital statistics was 11.2‰ LB in Santa Catarina and 28.7‰ LB in Amapá.[7]

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