Impact of the family health program on infant mortality in Brazilian municipalities.
OBJECTIVE
We evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level.


METHODS
We collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. We performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables.


RESULTS
We observed a statistically significant negative association between FHP coverage and infant mortality rate. After we controlled for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period.


CONCLUSIONS
The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities.
Aquino
Rosana
R
Instituto de Saúde Coletiva, Federal University of Bahia, Rua Basílio da Gas/n, Canela, CEP. 40.110-140. Salvador, Bahia, Brazil. aquino@ufba.br
de Oliveira
Nelson F
NF
Barreto
Mauricio L
ML
D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005192:Family Health; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D012044:Regression Analysis; D014505:Urban Population