Abstract
This study sought to analyze the correlation of the quality of Primary Health Care services in reducing child mortality, via geoprocessing. It involved an ecological study, with a cross-sectional approach, in which secondary data from all 5,565 Brazilian municipalities were used to analyze the infant mortality rate (IMR) and cause of infant death. The data related to IMR was obtained from the Mortality Information System. For the spatial analysis, 5,011 municipalities were included. The clustering analyses were performed using GEODA software and the spatial regression analyses were performed using ARCGIS 10.5 software. In Brazil, there was a 45.07% reduction in IMR between the years 2000 and 2015. The greatest reduction occurred in the northeastern region of the country, although it is still the region with the highest IMR. Of the 749 municipalities analyzed in the differential cluster for infant death, 153 had high IMR. The areas with the greatest increase in IMR were found in the North and Northeast regions. In Brazil, IMR proved to be inversely associated with the accessibility to high complexity services, health management strata and population size, reference for childbirth, live birth rate, per capita income and unemployment rate. A progressive reduction in IMR was recorded between 2000 and 2015.
Highlights
Resumo Objetivou-se analisar a correlação da qualidade dos serviços da Atenção Primária na redução da mortalidade infantil, através do geoprocessamento
This study sought to analyze the correlation of the quality of Primary Health Care services in reducing child mortality, via geoprocessing
The data related to infant mortality rate (IMR) was obtained from the Mortality Information System
Summary
Cluster diferencial Local Moran's I Não significante (4.821) High-high(153) Low-Low(294) Low-High(211) High-Low(91). À exceção da região Sul, a maioria dos municípios das demais regiões apresentaram associação inversa entre taxa de nascidos vivos e MI, ou seja, quanto maior a taxa de nascidos vivos, menor a taxa de MI (Mapa Nascidos Vivos, Figura 3). Para o alcance do objetivo de desenvolvimento sustentável (ODS) referente à erradicação de óbitos evitáveis nos primeiros cinco anos de vida, definido pela ONU até o ano 2030, alguns estados brasileiros, com ênfase nos estados do Norte e Nordeste, ainda necessitam de maiores investimentos para que consigam reduzir as atuais taxas[16]. Apesar da crescente redução da TMI no Brasil, inclusive com a tendência de homogeneização das taxas entre as regiões brasileiras, mais avanços relacionados a aspectos socioeconômicos e demográficos e de serviços de saúde ainda são necessários.
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