ABSTRACT
Infant and childhood mortality rates in São Paulo fell by about 50% and 70% respectively between 1973 and 1983. However, surveys in 1973-74 and 1984-85 showed no change in the prevalence of protein-energy malnutrition, nor were there marked changes in the socioeconomic characteristics of the population. Improvements in water supply and the duration of breast-feeding possibly accounted for a 20% decrease in the infant mortality rate. It is proposed that the markedly improved coverage of health services may have played a large role in explaining the rest of the decrease. The control of malnutrition may not always be essential for lowering infant and child mortality in developing societies.
PIP: Between 1973-83 infant and child mortality rates in Sao Paulo, Brazil fell about 50% and 70% 2 health surveys were done: one in 1973-74 and a second one in 1984-85. Results from both surveys showed that moderate and severe cases of malnutrition were rare; the prevalence of severe cases was below 1%. The most important finding regarding causes of declines in mortality rates for children under 5 was that this was not accompanied by any significant changes in the prevalence of malnutrition. Therefore, reductions in the prevalence of malnutrition may not be an essential ingredient in lessening the death rates in developing countries. The authors used data on the relative risks for infant mortality (IM) from 2 studies in similar urban areas to assess the possible impact of other factors on mortality. The 1st study was a cohort study of risk factors for IM and the 2nd was a case-control study of IM due to infectious diseases. The indicators used were socioeconomic status, demographic, environmental, health care, and breastfeeding. The outcomes of the study demonstrated that changes in socioeconomic variables and in the prevalence of malnutrition do not explain reductions in infant and child mortality in Sao Paulo. However, expansion of the water supply and increase in breastfeeding could account for 20% of the IMR. One can also state that the expansion and quality of health care were instrumental in lowering the mortality rates.
Subject(s)
Child Health Services/supply & distribution , Infant Mortality , Mortality , Brazil , Breast Feeding , Child, Preschool , Demography , Environment , Health Surveys , Humans , Infant , Socioeconomic FactorsABSTRACT
Las tasas de mortalidad de lactantes y niños pequeños disminuyeron en Sao Paulo en alrededor de un 50 por ciento y un 70 por ciento respectivamente entre 1973 y 1983. Sin embargo, las encuestas realizadas en 1973-1974 y 1984-1985 no mostraron cambios en la prevalencia de malnutrición proteicoenergética y tampoco hubo cambios marcados en las características socioeconómicas de la población. Es posible que las mejoras realizadas en los sistemas de abastecimiento de agua y en la duración de la alimentación al pecho expliquen hasta un 20 por ciento de la reducción de la tasa de mortalidad de lactantes, Se sugiere que la notable mejora en la cobertura de los servicios de salud puede haber desempeñado una función importante en el resto de esta disminución. Es posible que la lucha contra la malnutrición no siempre sea indispensable para reducir la mortalidad de lactantes y niños pequeños en las sociedades en desarrollo
Subject(s)
Infant Mortality , Mortality , Health Surveys , Breast Feeding , Socioeconomic Factors , BrazilABSTRACT
Infant and childhood mortality rates in Sao Paulo fell by about 50 per cent and 70 per cent respectively between 1973 and 1983. However, surveys in 1973-74 and 1984-85 showed no change in the prevalence of protein-energy malnutrition, nor were there marked changes in the socioeconomic characteristics of the population. Improvements in water supply and the duration of breast-feeding possibly accounted for a 20 per cent decrease in the infant mortality rate. It is proposed that the markedly improved coverage of health services may have played a large role in explaining the rest of the decrease. The control of malnutrition may not always be essential for lowering infant and child mortality in developing societies
