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Type: Artigo
Title: Can the primary health care model affect the determinants of neonatal, post-neonatal and maternal mortality? A study from Brazil
Author: Guerra, Alexandre Bergo
Guerra, Luciane Miranda
Probst, Livia Fernandes
Gondinho, Brunna Verna Castro
Ambrosano, Glaucia Maria Bovi
Melo, Estevao Azevedo
Brizon, Valeria Silva Candido
Bulgareli, Jaqueline Vilela
Cortellazzi, Karine Laura
Pereira, Antonio Carlos
Abstract: The state of SAo Paulo recorded a significant reduction in infant mortality from 1990 to 2013, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality (considering the neonatal and post-neonatal dimensions) and maternal mortality in the state of SAo Paulo, Brazil.MethodsIn this ecological study, data from national official open sources were used to conduct a population-based study. The units analyzed were 645 municipalities in the state of SAo Paulo, Brazil. For each municipality, the infant mortality (in both neonatal and post-neonatal dimensions) and maternal mortality rates were calculated for every 1000 live births, referring to 2013. Subsequently, the association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. For statistical analysis, we used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted p at 5%.ResultsThe increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates.ConclusionsIt was concluded that the Family Health Care Strategy was a Primary Care organization model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model when planning the organization of Primary Care services for the population
Subject: Mortalidade materna
Country: Reino Unido
Editor: Springer Nature
Rights: Aberto
Identifier DOI: 10.1186/s12913-019-3953-0
Date Issue: 2019
Appears in Collections:FOP - Artigos e Outros Documentos

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