The quality of care of very low birth weight babies in Brazil

Abstract

This issue of the Jornal de Pediatria publishes an interesting paper on health services research analyzing the mortality of very low birth weight (VLBW) babies born in maternity hospitals with neonatal intensive care units (NICU) in 2002-2003 in Fortaleza Ceara Brazil. As the authors rightly state this birth weight group although being less than 2% of the total live births require a high-quality hospital care and account for a substantial and growing proportion of neonatal and infant mortality. The paper shows that the neonatal and overall hospital mortality rates of Fortalezas VLBW babies are much higher than those observed in a network of NICUs in the United States for all birth weight groups. Birth weight-specific intrahospital mortality is an indicator of quality of care and this initial comparison with NICUs of a highly developed country may put the target too far. However the authors also show that the mortality rates in Fortaleza are higher for all birth weight groups than thoseobserved in Montevideo Uruguay. Here we should be much more concerned about the magnitude of our avoidable deaths considering that there are no relevant differences in the available technology and human resources for the care of newborns between the two cities. (excerpt)