Correcao de informacoes vitais: estimacao da mortalidade infantil, Brasil, 2000-2009

Abstract

OBJECTIVE:To propose a simplified method of correcting vital information and estimating the coefficient of infant mortality in Brazil. METHODS:Vital data in the information systems on mortality and live births were corrected using correction factors, estimated based on events not reported to the Brazilian Ministry of Health and obtained by active search. This simplified method for correcting vital information for the period 2000-2009 for Brazil and its federal units establishes the level of adequacy of information on deaths and live births by calculating the overall coefficient of mortality standardized by age and the ratio between reported and expected live births, respectively, in each Brazilian municipality. By applying correction factors to the number of deaths and live births reported in each county, the vital statistics were corrected, making it possible to estimate the coefficient of infant mortality. RESULTS:The highest correction factors were related to infant deaths, reaching values higher than 7 for municipalities with very precarious mortality information. For deaths and live births, the correction factors exhibit a decreasing gradient as indicators of adequacy of the vital information improve. For the year 2008, the vital information corrected by the simplified method per state were similar to those obtained in the research of active search. Both the birth rate and the infant mortality rate decreased in the period in all Brazilian regions. In the Northeast, the annual rate of decline was 6.0%, the highest in Brazil (4.7%). CONCLUSIONS:The active search of deaths and births allowed correction factors to be calculated by level of adequacy of mortality information and live births. The simplified method proposed here allowed vital information to be corrected per state for the period 2000-2009 and the progress of the coefficient of infant mortality in Brazil, its regions and states to be assessed.

Adequação das informações de mortalidade e correção dos óbitos informados a partir da Pesquisa de Busca Ativa

“…The survey occurred in a probabilistic sample of 79 small and medium-sized municipalities (all but one with fewer than 100,000 inhabitants) in 19 states, including all states in the North and Northeast regions and the states of Minas Gerais, Mato Grosso, and Goiás; these states are known to have poor data quality 13 . Sample selection was stratified by groups based on two criteria: age-standardized mortality rate for the period 2009-2011, and infant mortality rate.…”

“…We then used the correction factors demonstrated previously to calculate the corrected number of Live Births according to ranges of the Live Birth Ratio (ratio between recorded and estimated number of live births) 13 . …”

“…In addition, since 2000, three Proctive Search surveys were carried outto identify unreported vital statistics events. The aims of the first two surveys were to validate the criteria for adequacy of vital information and to estimate the coverage of the SIM and SINASC in Brazilian states and the Federal District (hereafter referred to as Unidades Federativas or UFs) 8,12,13 . The third Proactive Search survey only searched for unreported deaths.…”

“…Data from this survey was critical to develop maternal and infant indicators in the UFs using vital statistics data. By using correction factors estimated according to the level of adequacy of information on deaths and live births, it was possible to generalize the methodology to other years 13,14 . This represented a large shift in the way mortality indicators were calculated in Brazilpreviously indirect demographic methods were used to estimate mortality for all states of the North and Northeast regions as well as for the states of Minas Gerais, Mato Grosso and Goiás 15 .…”

“…These gaps hinder the use of information on mortality and live births in several Brazilian municipalities [11][12][13]16,17 . Based on the findings of the Proactive Search of Deaths carried out in 2014, related to events occurred in 2012, the present study aims to create adequacy indicators of the coverage of mortality data, calculate correction factors for indicators produced with data from the SIM by sex and age group, and estimate the Infant Mortality Ratio (IMR) in 19 Brazilian states and in municipalities where the correction was insufficient, seeking to establish priorities for intervention in places where deficiency in the data registry still persist.…”