Banca de DEFESA: CRISTIANE DA SILVA RAMOS MARINHO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : CRISTIANE DA SILVA RAMOS MARINHO
DATE: 28/05/2021
TIME: 14:00
LOCAL: ONLINE
TITLE:

CHILD MORTALITY IN BRAZIL,  RIO GRANDE DO NORTE AND THE PUBLIC POLICIES.

KEY WORDS:

Child health. Mortality. Disparities in health levels. Public policy. Coronavirus infections.

PAGES: 110
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Saúde Pública
SUMMARY:

The mortality of children in Brazil showed a reduction considered in the last years, however, unevenly between the different regions and Brazilian states, due to the great and important national differences. A macro-regional analysis revealing the Northeast region of Brazil as the one that most reduced childhood mortality. The state of Rio Grande do Norte reached a reduction of more than 80% in child and the under-five mortality rate in the last four decades. It is emphasized that the monitoring of infant and childhood mortality rates makes it possible to develop preventive strategies aimed at reducing the risk of death through public policies related to children's health. This thesis aims to analyze infant and under-five mortality in Brazil and Rio Grande do Norte, their associated factors and the intervening public policies. Four studies were developed: 1) descriptive and reflective study about the trajectory of public health and social policies for children in Brazil. The different strategies, programs and public health and social policies developed over the years were essential to achieve reductions in infant and under-five mortality rates in Brazil; 2) ecological study using secondary data for Brazil according to Intermediate Urban Linkage Regions from 2001 to 2017. Analyses of tendencies were performed with joinpoint and multiple linear regression models. Low income (extreme poverty) in the children’s families and absence of maternal schooling were the variables most closely correlated with underfive mortality rate (r = 0.649, p < 0.001 and r = 0.640, p < 0.001, respectively); 3) a time-series ecological study for 1979 and 2019 was conducted with Rio Grande do Norte as the unit of analysis. The annual percentage change (APC) was calculated using the Joinpoint software. The study showed a significant reduce trend between the years 1979 and 2005, AAPC = -6.13; 95% CI: -6.8; -5.5, for the infant mortality rate, and AAPC = -5.87; 95% CI: -6.6; -5.1, for the children mortality rate of aged 1 to 4 years.  As for the basic causes of death, the complications of pregnancy, childbirth, puerperium / conditions originating in the perinatal period and external causes showed an increasing behavior in the proportionality of infant and children deaths from 01 to 04 years, respectively, over the period studied; 4) cross-sectional study in a secondary database of Epidemiological Surveillance Sub-coordinator (SUVIGE), of the State Health Secretariat of Rio Grande do Norte of children notified with COVID-19 during 2020. Mortality from COVID-19 in children predominated in those aged between 1 and 4 years old, male, race / brown color, who had some kind of comorbidity, who needed to use ventilatory support, needed ICU admission and lived in the metropolitan region of Natal, capital of Rio Grande do Norte. Infant and childhood mortality is directly influenced by public health and social policies, with a stronger impact on the integrated presence of these types of policies, however, being able to change its pattern even in the face of fragmented and / or isolated.

BANKING MEMBERS:
Presidente - 421717 - MARIA ANGELA FERNANDES FERREIRA
Interna - 106.578.944-00 - GRÁCIA MARIA DE MIRANDA GONDIM - ENSP
Externa ao Programa - 2344942 - JOVANKA BITTENCOURT LEITE DE CARVALHO
Externa à Instituição - SILVIA WANICK SARINHO - UFPE
Externo à Instituição - PAULO GERMANO DE FRIAS - IMIP