| Popis: |
Data relating to infant mortality in Salvador, Brazil, were analyzed in order to determine how infant mortality evolved in various parts of the city during the period 1980-1988. This analysis showed sharp drops in the numbers of infant deaths, proportional infant mortality (infant deaths as a percentage of total deaths), and the infant mortality coefficient (infant deaths per thousand live births) during the study period despite deteriorating economic conditions. It also suggested that while these declines occurred throughout the city, the overall distribution of infant mortality in different reporting zones remained uneven. Among other things, these findings call attention to a need for further investigation of the roles played by various health measures (including immunization, control of respiratory and diarrheal diseases, encouragement of breast-feeding, and monitoring of growth and development) and of reduced fertility (resulting from birth spacing, use of contraceptives, and female sterilization) in bringing about declines in infant mortality during hard economic times.Infant mortality has declined since the 1940s in the Americas and specifically in Brazil. Infant mortality in Brazil was 65 deaths/1000 live births regardless of the recession. The aim of this study was to determine the patterns of change in infant mortality in 76 reporting zones in Salvador, Brazil, between 1980 and 1988, based on death records and decedent's place of residence. Data were analyzed in terms of changes in proportional infant mortality and the infant mortality coefficient. Quartiles were set at low (3.9 to 17.1 deaths/100 total deaths), intermediate (17.9 to 25.8), and high (37.5 to 52.5). Averages of each quartile were computed for 1980 and 1988 and compared. Live birth rates were used in computing the infant mortality coefficients; deaths/1000 live births were grouped by low, intermediate, and high, and average values calculated for 1980 and 1988. The problems of distortion in using these data are discussed. The results show declines in proportional infant mortality from 17.4% to 30.8% of total mortality and in infant mortality coefficients from 71.9 to 31.6 deaths/1000 live births. Proportional infant mortality declined by 43.5% between 1980 and 1988; the coefficient of infant mortality decreased by 56.1% for the same period. The absolute number of deaths also declined. In the quartile analysis, the rates of decline were greatest for intermediate, high, and very high proportional infant mortality and for the coefficient of infant mortality. There was also uneven distribution of deaths in different quartiles. The geographic location of reporting zones is visually displayed; it is apparent that there were few very high zones in 1988 and a sharp reduction in high zones for proportional infant mortality. The map of average infant mortality coefficients shows marked declines in very high zones; there were increases in areas with low and intermediate coefficients. Suggestions for additional research were to evaluate a longer time series and to analyze the influence of socioeconomic change on the declines. |
