Infant mortality by color or race from Rondônia, Brazilian Amazon

Abstract

OBJECTIVE To analyze the quality of records for live births and infant deaths and to estimate the infant mortality rate for skin color or race, in order to explore possible racial inequalities in health.METHODS Descriptive study that analyzed the quality of records of the Live Births Information System and Mortality Information System in Rondônia, Brazilian Amazonian, between 2006-2009. The infant mortality rates were estimated for skin color or race with the direct method and corrected by: (1) proportional distribution of deaths with missing data related to skin color or race; and (2) application of correction factors. We also calculated proportional mortality by causes and age groups.RESULTS The capture of live births and deaths improved in relation to 2006-2007, which required lower correction factors to estimate infant mortality rate. The risk of death of indigenous infant (31.3/1,000 live births) was higher than that noted for the other skin color or race groups, exceeding by 60% the infant mortality rate in Rondônia (19.9/1,000 live births). Black children had the highest neonatal infant mortality rate, while the indigenous had the highest post-neonatal infant mortality rate. Among the indigenous deaths, 15.2% were due to ill-defined causes, while the other groups did not exceed 5.4%. The proportional infant mortality due to infectious and parasitic diseases was higher among indigenous children (12.1%), while among black children it occurred due to external causes (8.7%).CONCLUSIONS Expressive inequalities in infant mortality were noted between skin color or race categories, more unfavorable for indigenous infants. Correction factors proposed in the literature lack to consider differences in underreporting of deaths for skin color or race. The specific correction among the color or race categories would likely result in exacerbation of the observed inequalities.

Iniquidades étnico-raciais nas hospitalizações por causas evitáveis em menores de cinco anos no Brasil, 2009-2014

“…As principais causas de internação foram doenças do aparelho respiratório (37,4%) e infecciosas e parasitárias (19,3%), sendo as crianças indígenas as mais acometidas. As taxas brutas de ICSAP (por 1.000) foram mais elevadas em indígenas (97,3; IC95%: 95, 2), seguidas das pardas (40,0;IC95%: 39,1), e as menores foram nas amarelas (14,8;IC95%: 14,(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)5). As maiores razões de taxas ajustadas de ICSAP foram registradas entre crianças de cor/raça indígena e branca - 5,7 (IC95%: 3,4) no país, atingindo 5,9 (IC95%: 5,0-7,1) e 18,5 (IC95%: 16,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]7) no Norte e Centro-oeste, respectivamente.…”

“…No Brasil, apesar das expressivas melhorias nos indicadores de morbimortalidade na infância 6 , desigualdades regionais e étnicas em saúde infantil vêm sendo sistematicamente apontadas 7,8,9,10,11 . Por exemplo, há poucos trabalhos publicados que analisam a morbidade hospitalar em crianças indígenas no país.…”

Mortalidade infantil por doenças infecciosas e parasitárias no estado do Pará

“…Estudos apontam que a primeira causa de mortalidade infantil no período pós-neonatal é presumivelmente devido a causas relacionadas a doenças infectoparasitárias. Sendo esta a terceira causa de mortalidade geral em menores de um ano 5,6 .…”

Follow-up consultations on growth and development: the meaning for quilombo mothers

“…2 With the implementation of GDM consultations, which aim to recognize situations that endanger children's health and provide early interventions, there was a significant reduction in infant mortality between 2000 and 2010, when the rate dropped by 47.6%. 1,3 Despite the reduction of mortality rates over the years, Black children still have a greater risk of becoming ill or dying. In the United States, the probability of a child dying before the age of five is 1 in 140 live births, while in sub-Saharan Africa this probability increases to 1 in 12 births.…”

“…9 Added to these issues is the unsatisfactory degree of adherence of children to GDM consultations with this problem being considered a challenge for health services. Among the reasons are the lack of understanding of the mothers about the need for these services 3 and the maintenance of traditional practices carried out in communities such as quilombos. In these communities, the way of taking care of newborns includes giving them foods, including types of porridge, in the first days of life; breastfeeding the children of other mothers; the use of non-aseptic substances, including harmful substances, when caring for the umbilical stump care; the positioning of the infant at bedtime, exposing it to reflux and consequently risk of aspiration and self-medications, especially the administration of herbs and teas, regardless of the child's age.…”