Banca de DEFESA: CAMILA DAYZE PEREIRA SANTOS

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : CAMILA DAYZE PEREIRA SANTOS
DATA : 07/12/2018
HORA: 14:30
LOCAL: Departamento de Nutrição - UFRN
TÍTULO:

Temporal distribution of Infant Mortality in a capital of Northeastern Brazil, 2006-2013: reflections on the quality of Primary Health Care.

PALAVRAS-CHAVES:

Infant Mortality; Causes of death; Primary Health Care; Quality of Health Care.

PÁGINAS: 58
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
SUBÁREA: Epidemiologia
RESUMO:

The objective of this study was to analyze the temporal distribution of infant deaths, bio sociodemographic factors related to infant mortality, the main causes, type of avoidance of death and factors related to the quality of maternal and child health care in Primary Health Care in Natal / RN, between 2003 and 2016, before and after the Pact for the Reduction of Infant Mortality in the Northeast and Legal Amazon (PRMI) (2003-2009 and 2010-2016 respectively). Ecological study, of a time series, carried out with data from the Mortality Information System. Infant mortality rates (IMR), neonatal (TMN) and post-neonatal (MTP), and IMR due to death and type of avoidance of death were calculated for each year evaluated. The join point method was used to calculate the Annual Percentage Change (APC). The bio sociodemographic variables were analyzed: sex, race, type of gestation, type of delivery, gestational age, and birth weight, comparing the periods of 2003-2009 and 2010-2016. To assess the association of these variables and the occurrence of infant death in the neonatal and post-neonatal period, the prevalence ratio (PR) and the 95% confidence interval were calculated. To evaluate the quality of care in Primary Care (AB), data from the Program for Improving Access and Quality of Primary Care (PMAQ-AB) 2014 were used. IMR significantly reduced -12.74% (95% CI -23.9 (-7.01% / year) and in endocrine and nutritional diseases (16.21% / year), between 2007 and 2011. From the causes of death, there was a significant reduction only in deaths due to respiratory diseases. The probability of avoidable death was higher in neonatal mortality for both 2003-2009 and 2010-2016 periods. From the bio sociodemographic variables analyzed, the type of gestation, gestational age at birth and birth weight were associated with neonatal mortality, with a higher probability of dying in the neonatal period; of twin gestation; premature and that presented very low birth weight in the two periods analyzed. Regarding maternal and child care, there was a significant increase in the number of pregnant women who performed more than 7 prenatal consultations (4.1% / year between 2003 and 2009) and the number of neonatal ICU beds (8.5% / year between 2005-2016). Of the total number of infant deaths, 1836 (71.7%) occurred due to preventable causes, the highest proportion being reduced by adequate attention to women during pregnancy (38%), which showed a tendency to increase between 2010 and 2016 (APC 6.59%). Regarding the quality of prenatal care, some indicators were found that may have a negative impact on the infant mortality rate: referral consultation (7.4%); existence of a system that alerts to the probable date of birth (10.2%); (34.7%) and early capture of pregnant women and complications during pregnancy (45.3%). It is concluded that PRMI's objective of reducing the IMR by 5% per year in 2009 and 2010 in Natal / RN was reached, but there was an upward trend in the succeeding years, which showed that efforts, were insufficient to keep infant mortality in decline. There is still a high occurrence of deaths due to preventable causes and failures in Primary Care assistance observed due to the low supply of some agreed maternal and child health indicators.

MEMBROS DA BANCA:
Presidente - 2149611 - CLELIA DE OLIVEIRA LYRA
Interno - 1868020 - ZENEWTON ANDRÉ DA SILVA GAMA
Externo à Instituição - DIRCE MARIA LOBO MARCHIONI - USP