Wanessa da Silva de Almeida1, Célia Landmann Szwarcwald. 1. Laboratório de Informações em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. walmeida@icict.fiocruz.br
Abstract
OBJECTIVE: To analyze geographic access to hospital childbirth in Brazilian municipalities. METHODS: Information on deaths and births were analyzed in regards to appropriateness for calculating the infant mortality rate during the period 2005 to 2007, for the 5,564 Brazilian municipalities. Indicators of supply and geographic access to health services were calculated to express hospital childbirth access. A multivariate regression model was used to test the association between geographic access to childbirth and the infant mortality rate in municipalities with adequate vital information. RESULTS: Of the municipalities analyzed, 56% had adequate vital information, corresponding to 72% of Brazil's population. The geographic distance between the municipality of residence and municipality of hospitalization was inversely associated to population size, per capita income and the infant mortality rate, even when controlling for demographic and socioeconomic factors. CONCLUSIONS: Although important strategies have been developed in Brazil to improve the quality of care for pregnant women, actions to guarantee equal access to childbirth services are still insufficient. Large geographic distance to childbirth facility was identified as a risk factor for infant mortality, together with unequal supply of quality health services and lack of integration with primary care.
OBJECTIVE: To analyze geographic access to hospital childbirth in Brazilian municipalities. METHODS: Information on deaths and births were analyzed in regards to appropriateness for calculating the infant mortality rate during the period 2005 to 2007, for the 5,564 Brazilian municipalities. Indicators of supply and geographic access to health services were calculated to express hospital childbirth access. A multivariate regression model was used to test the association between geographic access to childbirth and the infant mortality rate in municipalities with adequate vital information. RESULTS: Of the municipalities analyzed, 56% had adequate vital information, corresponding to 72% of Brazil's population. The geographic distance between the municipality of residence and municipality of hospitalization was inversely associated to population size, per capita income and the infant mortality rate, even when controlling for demographic and socioeconomic factors. CONCLUSIONS: Although important strategies have been developed in Brazil to improve the quality of care for pregnant women, actions to guarantee equal access to childbirth services are still insufficient. Large geographic distance to childbirth facility was identified as a risk factor for infant mortality, together with unequal supply of quality health services and lack of integration with primary care.
Authors: Sonia Duarte de Azevedo Bittencourt; Rosa Maria Soares Madeira Domingues; Lenice Gnocchi da Costa Reis; Márcia Melo Ramos; Maria do Carmo Leal Journal: Reprod Health Date: 2016-10-17 Impact factor: 3.223
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Authors: Jennifer M Ross; Nathaniel J Henry; Laura A Dwyer-Lindgren; Andrea de Paula Lobo; Fatima Marinho de Souza; Molly H Biehl; Sarah E Ray; Robert C Reiner; Rebecca W Stubbs; Kirsten E Wiens; Lucas Earl; Michael J Kutz; Natalia V Bhattacharjee; Hmwe H Kyu; Mohsen Naghavi; Simon I Hay Journal: BMC Med Date: 2018-09-06 Impact factor: 8.775