title: Sub-national assessment of inequality trends in neonatal and child mortality in Brazil.
abstract: OBJECTIVE
  Brazil's large socioeconomic inequalities together with the increase in neonatal mortality jeopardize the MDG-4 child mortality target by 2015. We measured inequality trends in neonatal and under five mortality across municipalities characterized by their socio-economic status in a period where major pro poor policies were implemented in Brazil to infer whether policies and interventions in newborn and child health have been successful in reaching the poor as well as the better off.
  
  
  METHODS
  Using data from the 5,507 municipalities in 1991 and 2000, we developed accurate estimates of neonatal mortality at municipality level and used these data to investigate inequality trends in neonatal and under five mortality across municipalities characterized by socio-economic status.
  
  
  RESULTS
  Child health policies and interventions have been more effective in reaching the better off than the worst off. Reduction of under five mortality at national level has been achieved by reducing the level of under five mortality among the better off. Poor municipalities suffer from worse newborn and child health than richer municipalities and the poor/rich gaps have increased.
  
  
  CONCLUSIONS
  Our analysis highlights the importance of monitoring progress on MDGs at sub-national level and measuring inequality gaps to accurately target health and inter-sectoral policies. Further efforts are required to improve the measurement and monitoring of trends in neonatal and under five mortality at sub-national level, particularly in developing countries and countries with large socioeconomic inequalities.
authors.affiliation: Initiative for Global Health, Harvard University, Cambridge, USA. msousa@hsph.harvard.edu.
authors.forename: Angelica
authors.initials: A
authors.lastname: Sousa
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hill
authors.forename: Mario R
authors.initials: MR
authors.lastname: Dal Poz
references.citation: Cad Saude Publica. 2008;24 Suppl 1:S159-72
references.pmid: 18660900
references.citation: Sao Paulo Med J. 2001 Jan 4;119(1):33-42
references.pmid: 11175624
references.citation: Cad Saude Publica. 2007 Jul;23(7):1511-28
references.pmid: 17572800
references.citation: Cad Saude Publica. 2002 Nov-Dec;18(6):1725-36
references.pmid: 12488900
references.citation: Cad Saude Publica. 2007 May;23(5):1207-16
references.pmid: 17486242
references.citation: Am J Public Health. 2008 Apr;98(4):692-68
references.pmid: 17761568
references.citation: Am J Public Health. 2009 Jan;99(1):87-93
references.pmid: 19008516
references.citation: Soc Sci Med. 2002 Dec;55(12):2083-92
references.pmid: 12409122
references.citation: Health Policy Plan. 2010 Jul;25(4):253-61
references.pmid: 20123940
references.citation: Lancet. 2003 Jul 26;362(9380):323-7
references.pmid: 12892965
references.citation: Rev Panam Salud Publica. 2009 Dec;26(6):478-84
references.pmid: 20107701
references.citation: Cad Saude Publica. 2005 Sep-Oct;21(5):1602-8
references.pmid: 16158168
references.citation: Lancet. 2008 Apr 12;371(9620):1259-67
references.pmid: 18406860