Efeito da Estratégia Saúde da Família na vigilância de óbitos infantis

Abstract

OBJECTIVE:To evaluate the effect of the Family Health Strategy on infant mortality surveillance. METHODS:An ecologic study was performed with a multiple group design, and the unit of analysis was municipalities in Bahia state (Northeastern Brazil) in 2008. The 3,947 deaths analyzed were obtained from the Mortality Information System, and the minimum acceptable level for death investigation was 25%. Logistic regression models were used for bivariate and multivariate analysis and adjusted for sociodemographic and service organization variables. RESULTS:In 48.9% of the municipalities at least one infant death was investigated, and 35.5% of municipalities achieved the minimum target for investigation. In the bivariate model, the investigation of at least one infant death was statistically associated with more populous municipalities, higher Human Development Indices, existence of Investigation Committee and obstetric beds in the municipality; there were no associations with Family Health Strategy coverage and existence of a designated person in the municipality. In multivariate models, the investigation of at least one infant death was statistically associated with population size (OR = 4.02) and presence of obstetric beds (OR = 2.68). Achieving the minimum target was associated only with the existence of obstetric beds in the municipality (OR = 1.76). CONCLUSIONS:The investigation rate for deaths of children less than one year of age was less than the level agreed upon in Bahia in 2008. There was no association between coverage of the Family Health Strategy and death investigations, which suggests that Infant Mortality Surveillance is at an incipient stage, especially in regards to decentralization to local primary care teams.

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

“…9 A committee to monitor mortality data a has been recently created to improve and regulate the flow of information. Commissions were also set up to investigate infant deaths in various municipalities, 14 contributing to improvements in data recording.…”

Atenção integrada às doenças prevalentes na infância: prática do enfermeiro

“…These are worrying problems, given that in the consultations the child has been suffering very serious consequences, interfering directly in their healthy growth. 17 Given the analysis of the data obtained in this integrative review, some difficulties were found in the application of IMCI, either in the structural aspect of the primary care network or because of lack of knowledge of the nurse in the protocol development. But, even with restrictions, it does not exempt the nurse from developing integrated child care.…”

Correction of vital statistics based on a proactive search of deaths and live births: evidence from a study of the North and Northeast regions of Brazil

“…The proactive search made it possible to identify problems in the implementation of vital information systems at the municipality level, to propose interventions to reduce local irregularities, and to develop a method to correct vital statistics in the 2000s. The investigation of death conditions among infants and the routine use of active search procedures by local health services, as recommended by the current health surveillance policies, should be implemented in problematic municipalities [12,36] to continue the process of reducing infant mortality in Brazil and to support pragmatic and viable alternatives in different social contexts.…”