Tackling health inequities in Chile: maternal, newborn, infant, and child mortality between 1990 and 2004.
OBJECTIVE
We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions.


METHODS
Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4,000,000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles.


RESULTS
During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100,000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile.


CONCLUSIONS
During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions.
Gonzalez
Rogelio
R
Pontificia Catholic University of Chile, and the Division of Prevention and Control of Diseases, Chilean Ministry of Health, Santiago, Chile. rogonzalez@minsal.gov.cl
Requejo
Jennifer Harris
JH
Nien
Jyh Kae
JK
Merialdi
Mario
M
Bustreo
Flavia
F
Betran
Ana Pilar
AP
D016009:Chi-Square Distribution; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008297:Male; D008428:Maternal Mortality / Q000639:trends*; D012307:Risk Factors; D012959:Socioeconomic Factors