Abstract
Infant mortality expresses a set of living, working and healthcare access conditions and opens up possibilities for adopting interventions to expand equity in healthcare. This study aimed to investigate vulnerability and the consequent differences in access to health services and occurrences of deaths among infants under one year of age in the municipality of Embu. This was a descriptive study in the municipality of Embu. Primary data were collected through interviews with the families of children living in the municipality of Embu who died in the years 1996 and 1997 before reaching one year of age. Secondary data were obtained from death certificates. The variables collected related to living conditions, income, occupation, prenatal care, delivery and the healthcare provided for children. These data were compared with the results obtained from a study carried out in 1996. Statistically significant differences were found with regard to income, working without a formal employment contract and access to private health plans among the families of the children who died. There were also differences in access to and quality of prenatal care, frequency of low birth weight and neonatal inter-ocurrences. The employment/unemployment situation was decisive in determining the degree of family stability and vulnerability to the occurrence of infant deaths, in addition to the conditions of access to and quality of healthcare services.
Highlights
Because infant mortality expresses a set of living, working and healthcare access conditions, it is one of the indicators used in studies dealing with social inequalities and seeking to comprehend the complex determination of the health-illness process
Statistically significant differences were found with regard to income, working without a formal employment contract and access to private health plans among the families of the children who died
The employment/unemployment situation was decisive in determining the degree of family stability and vulnerability to the occurrence of infant deaths, in addition to the conditions of access to and quality of healthcare services
Summary
Because infant mortality expresses a set of living, working and healthcare access conditions, it is one of the indicators used in studies dealing with social inequalities and seeking to comprehend the complex determination of the health-illness process. Social inequity and poor living conditions constitute the principal barriers to advances and improvements in the whole population’s health situation.[3] In Embu, a municipality in the Metropolitan Region of São Paulo, the infant mortality rate was one of the highest in the State of São Paulo until the middle of the 1990s. It presented significant falls from 1996 onwards (when it was 28.1 per thousand live births), to reach 11.2 in 2006.4 This decrease occurred in relation to both neonatal and post-neonatal infant mortality. Other factors may have contributed towards the reduction in the neonatal and post-neonatal components of infant mortality in this municipality: expansion of the primary healthcare services and the diagnostic and therapeutic support; development of a regular program of full healthcare for children (which among other actions provides disease prevention and timely care for the most prevalent illnesses, respiratory infections); and in 1999, the creation of a general referral hospital for medium and high-risk pregnancies with a neonatal intensive care unit and a pediatric ward, in this region
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Schedule a callMore From: Sao Paulo medical journal = Revista paulista de medicina
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