Tendências da mortalidade infantil no Estado do Espírito Santo, Brasil, 1979 a 2004 / Childhood mortality trends in the State of Espírito Santo, Brazil,1979-2004

A taxa de mortalidade infantil é utilizada como indicador da qualidade de vida das nações, da organização dos serviços de saúde e da assistência e, no Brasil, é observada uma tendência à queda deste indicador. Objetivo do presente estudo foi identificar as tendências da mortalidade infantil da série histórica dos coeficientes de mortalidade infantil e de seus componentes no Estado do Espírito Santo no período de 1979 a 2004. Trata-se de um estudo de série histórica cuja fonte de dados é composta pelos bancos de dados do SIM, IBGE e SINASC. As análises das tendências constituem-se de cálculos das retas de regressão linear para o coeficiente de mortalidade infantil e de seus componentes pelo programa SPSS, versão 12.0 e o programa MicrosoftOffice Excel, versão 2003. As tendências do coeficiente de mortalidade infantil e seus componentes no Estado do Espírito Santo são decrescentes e estatisticamente significantes(p<0,0001). O componente pós-neonatal apresenta-se como maior índice de queda e o neonatal como o que mais contribui para a mortalidade infantil, devido ao elevado número de mortes neonatais precoces. De todos os componentes da mortalidade infantil, o que apresenta menor redução é o neonatal tardio. É necessária a intensificação de esforços na tentativa de ampliar o acesso à assistência materno-infantil com qualidade a fim de reduzir as altas taxas de mortalidade neonatal, especialmente a neonatal precoce.

Childhood mortality rate, used as an indicator of the qualityof life of nations and of the organization of health careservices, has been falling in Brazil. This study attempted toidentify childhood mortality trends through the historicalseries of the state of Espírito Santo, Brazil, during the period1979-2004. The data were obtained from the BrazilianMortality Information System (SIM), Geography and StatisticsInstitute (IBGE) and Live Birth Information System(SINASC) databanks. Trend analyses were made throughlinear regression calculations for the childhood mortalityrate and its components, with the SPSS version 12.0 andMicrosoft Office Excel, version 2003 programs. Therewas a statistically significant (p<0.0001) decreasing trendfor the childhood mortality rate and its components in thestate of Espírito Santo. While the post-neonatal componentexperienced the largest decrease, the neonatal componentwas the greatest contributor to childhood mortality, dueto the large number of early neonatal deaths. Of all thecomponents of childhood death, the smallest reduction wasseen in the late neonatal period. Improved access to qualitymother-child care is necessary to reduce the high neonatalmortality rates, especially early neonatal ones.

[The estimation of Chilean mortality (1860-1940): limits and possibilities]. / La estimacion de la mortalidad chilena (1865-1940): limites y posibilidades.

PIP: The limitations and errors in data sources, primarily censuses and vital statistics, concerning mortality in Chile from 1865 to 1940 are examined. Solutions are offered to adjust the sources' underestimations, particularly with regard to infant mortality.^ieng

The social bases of declining infant mortality: lessons from a nineteenth-century Italian town.

PIP: A detailed study of the factors associated with the decline of infant mortality in the town of Casalecchio di Reno, near Bologna, Italy, from 1865-1921 was generated from household tax records, birth and death registers, census data, and a variety of scholarly sources. Infant mortality had been 400/1000 in 17th century, fell to about 250 in the mid 18th, to 186 from 1865-1880, to 100 in 1900, and 75 in 1910. Infant mortality was lower among merchant and sharecropper families who had decent housing, food and water, higher among daily wage workers who lived in filthy crowded apartments on marginal incomes, and much higher among women who worked in emerging textile factories who could not breastfeed and used animal milk (682/1000 in 1903). Results are expressed in terms of probability of an infant death for specific demographic or maternal characteristics. Infant deaths among wage working women began to fall after 1902 when the government regulated child and female labor, requiring post-partum leave and time to breastfeed. The fact that factory workers were literate and urbanized did not help their children survive until they received better water, sewage systems, free medical care, and better housing. Thus, infant mortality varied in subgroups, was not necessarily lower in "modern" urban classes, and its fall depended on direct government intervention.^ieng

Some aspects of infant mortality in Alexandria, Egypt: a study in medical geography.

PIP: Data derived from vital statistics records was used to analyze trends and patterns in infant death rates in Alexandria, Egypt from 1951-1965. The infant death rate declined from 168/1000 live births to 150/1000 live births between 1951-1965. This decline was observed in all districts of Alexandria and the decline was greatest in those districts which had the highest rates in 1951. During the last 10 years the infant death rate was less than 140/1000 in 4 districts, between 140-160/1000 in 2 districts, and more than 160/1000 in 4 districts. Infant death rates were positively correlated with the degree of crowding in the district, the proportion of illiterate women of reproductive age in the district, and the proportion of industrial and craft workers living in a district. Infant death rates were highest during the 1st week of life and gradually declined until the 12th week. After the 12th week the rate remained constant. Deaths during the neonatal period were due mainly to endogenous causes, such as congenital defects. During the post neonatal period infant deaths were due primarily to environmental or exogenous causes. Endogenous death rates remained almost constant between 1951-1965 while exogenous death rates declined markedly. The 3 major causes of infant death were 1) gastro-enteritis; 2) congenital debility; and 3) pneumonia and bronchitis. In recent years pneumonia and bronchitis declined somewhat, and the proportion due to congenital debility remained about the same. Deaths due to infections and parasitic diseases increased from 1950-1961. Infant death rates were higher for males than for females during the early neonatal period but this difference disappeared by the end of the 1st year of life.^ieng

Infant mortality in the Algerian People's Democratic Republic.

PIP: Prior to the revolution in Algeria in 1969, the infant mortality rate for the native population was markedly higher than the rate for Europeans living in Algeria and the rate did not decrease for the native population during the colonial period. For the urban native population, the infant mortality rate was 3-5 times higher than the rate for Europeans living in urban areas of Algeria during the period 1954-1960. Rural rates were probably much higher. These high rates were due to a failure on the part of the colonial powers to provide adequately for the health care needs of the native population. Since the revolution, the mortality rate for infants has declined. The mean infant mortality rate for 1954-1960 was 102.4/1000 live births while the mean rate during the 7 years following the revolution was 78.3/1000 live births. This decrease reflects the improvements made in health care services by the Algerian People's Democratic Republic. During the colonial era there was only one medical school in Algeria; now there are three; and in 1977, 823 medical school students were graduated. During the period 1963-1972, the number of hospital beds increased by 17.8% and the number of physicians increased by 55.3%. During this same period the health budget doubled and now accounts for 5-7% of the national budget. Line graphs show 1) mortality, infant mortality, and child mortality rates for European and native populations in Algeria for 1954-1960; 2) infant mortality rates by race for Algeria, 1960-1970; and 3) infant mortality rates for France and for native and European Algerian populations for 1906-1960. (Summaries in GER, FRE, SPA).^ieng