Health capabilities and the determinants of infant mortality in Brazil, 2004–2015: an innovative methodological framework
| Autor: | Claude Sicotte, Roxane Borgès Da Silva, Ladislau Dowbor, Alexandre Bugelli |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Total fertility rate
Family income Infant mortality Health capabilities Public policies 03 medical and health sciences Social determinants of health 0302 clinical medicine Pregnancy Humans Medicine 030212 general & internal medicine Mortality Multilevel panel data with fixed effect nested within-clusters Child 030505 public health business.industry Research Mortality rate Infant Newborn Public Health Environmental and Occupational Health Infant Per capita income Child mortality Socioeconomic Factors Income Educational Status Household income Female Public aspects of medicine RA1-1270 0305 other medical science business Health economics Brazil Demography |
| Zdroj: | BMC Public Health, Vol 21, Iss 1, Pp 1-17 (2021) BMC Public Health |
| ISSN: | 1471-2458 |
| Popis: | BackgroundDespite the implementation of a set of social and health policies, Brazil has experienced a slowdown in the decline of infant mortality, regional disparities and persistent high death levels, raising questions about the determinants of infant mortality after the implementation of these policies. The objective of this article is to propose a methodological approach aiming at identifying the determinants of infant mortality in Brazil after the implementation of those policies.MethodA series of multilevel panel data with fixed effect nested within-clusters were conducted supported by the concept of health capabilities based on data from 26 Brazilian states between 2004 and 2015. The dependent variables were the neonatal, the infant and the under-five mortality rates. The independent variables were the employment rate, per capita income,Bolsa FamíliaProgram coverage, the fertility rate, educational attainment, the number of live births by prenatal visits, the number of health professionals per thousand inhabitants, and the access to water supply and sewage services. We also used different time lags of employment rate to identify the impact of employment on the infant mortality rates over time, and household income stratified by minimum wages to analyze their effects on these rates.ResultsThe results showed that in addition to variables associated with infant mortality in previous studies, such asBolsa FamíliaProgram, per capita income and fertility rate, other factors affect child mortality. Educational attainment, quality of prenatal care and access to health professionals are also elements impacting infant deaths. The results also identified an association between employment rate and different infant mortality rates, with employment impacting neonatal mortality up to 3 years and that a family income below 2 minimum wages increases the odds of infant deaths.ConclusionThe results proved that the methodology proposed allowed the use of variables based on aggregated data that could hardly be used by other methodologies. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|