Journal
CADERNOS DE SAUDE PUBLICA
Volume 30, Issue -, Pages -Publisher
CADERNOS SAUDE PUBLICA
DOI: 10.1590/0102-311X00133213
Keywords
Infant Mortality; Hospital Care; Health Services Evaluation; Parturition
Categories
Funding
- National Council for Scientific and Technological Development (CNPq)
- Science and Tecnology Department, Secretariat of Science, Tecnology, and Strategic Inputs, Brazilian Ministry of Health
- National School of Public Health, Oswaldo Cruz Foundation (INOVA Project)
- Foundation for supporting Research in the State of Rio de Janeiro (Faperj)
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This study examined neonatal deaths in the live-births cohort in the Birth in Brazil survey, which interviewed and examined medical records of 23,940 mothers from February 2011 to October 2012. Potential risk factors were analyzed using hierarchical modeling. Neonatal mortality rate was 11.1/1,000, the highest rates occurring in the North and Northeast regions and in lower social classes. Low birth weight, risks during pregnancy and conditions of the newborn were the main factors associated with neonatal death. Inadequate prenatal and childbirth care point to unsatisfactory quality of health care. Difficulty in gaining hospital admission for delivery, and children with birth weight < 1,500g born at hospitals without a neonatal intensive care unit, indicate gaps in health system organization. Deaths from intra-partum asphyxia in term babies and late prematurity express preventable neonatal mortality. Better quality health care, especially hospital care during labor and birth, poses the main public policy challenge to progress in reducing mortality and inequalities in Brazil.
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