[Differences between neonatal mortality and stillbirth rates in Brazil: a study based on the Unified Health System (SIH/SUS) Hospital Information System].
The main objective of this article is to estimate stillbirth and neonatal mortality rates in Brazilian States based upon the country's Hospital Information System. Analysis of 1995 data reveals contrasting rates between the various regions of the country. In order to elucidate the States' different rates, we focused on the association between indicators of coverage, utilization, and access to the Unified Health System (SUS). The results for the neonatal period mostly showed higher early neonatal mortality rates when compared to late neonatal mortality rates, higher neonatal mortality rates in the States comprising the South and Southeast regions, less variable rates between those States, and extremely low rates in some States of the North, Central-West, and Northeast regions. The limited supply of SUS services and low access to same are relevant constraints on health care for the population in the North and Northeast. Aspects related to quality of childbirth and neonatal care are also reflected in the rates studied. The findings suggest that spatial and temporal monitoring of these rates could provide analytical support for organizing the Maternal and Child Health Program.
de Andrade Schramm
J M
JM
Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ 21041-210, Brasil. joyce@ensp.fiocruz.br
Szwarcwald
C L
CL
D001938:Brazil / Q000453:epidemiology; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006751:Hospital Information Systems; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007256:Information Systems; D011247:Pregnancy