[Neonatal care and mortality in public hospitals in Rio de Janeiro, Brazil, 1994/2000].
This article analyzes an intervention by the Rio de Janeiro Municipal Health Department (SMS-RJ), Brazil, to reduce the neonatal mortality rate (strategies for organizing and upgrading neonatal care in the municipal system, including an increase in the number of neonatal high-risk beds). We studied the trends in neonatal mortality rate (1995/2000), neonatal care provided in different public hospitals (1994/2000), and admissions profile and mortality in four neonatal intensive care units (NICUs) under the SMS-RJ (2000). There was a concentration of high-risk neonatal care in the municipal hospitals (an increase from 28.0% of the care provided for live premature neonates in 1994 to 67.0% in 2000) and a reduction in the neonatal mortality rate in units under the Unified National Health System (from 19.9 deaths per thousand live births in 1996 to 15.5 in 2000). There was no reduction in the prematurity and low birth weight rates among mothers residing in the municipality of Rio de Janeiro. Analysis of admissions to the NICUs showed a high proportion of neonates born to mothers from municipalities outside Rio de Janeiro, while 14.0% of the mothers had not received prenatal care, and the mortality rate among newborns with birth weight < 1.500g was 32.0%.
Gomes
Maria Auxiliadora de Souza Mendes
MA
Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. maria@iff.fiocruz.br
Lopes
José Maria Andrade
JM
Moreira
Maria Elizabeth Lopes
ME
Gianini
Nicole Oliveira Mota
NO
D001938:Brazil / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006779:Hospitals, Public / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D050498:Live Birth; D008297:Male; D018743:Perinatal Care / Q000592:standards / Q000706:statistics & numerical data*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology