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New century, old problems: infant mortality trend and its components in the northeast region of Brazil

Abstract

Background

Infant mortality still represents a challenge for developing countries.

Objective

To assess the infant mortality trend and its components in the Brazilian Northeast states between 2001 and 2015.

Method

Ecological study consisting of four indicators of infant mortality were analyzed as following: general, early neonatal, late neonatal and post-neonatal mortalities. A regression analysis was applied to fit the inflection point (joinpoint regression). The trends were classified as increasing, decreasing or stationary. The Annual Percent Change (APC) was calculated considering a 95% confidence interval.

Results

Decreasing trend of overall infant mortality in the Northeast region (-3.9%) could be measured; the state of Pernambuco showed the greatest reduction (-5.2%). Regarding the early neonatal mortality, only the state of Maranhão showed stationary trends (-0.2%). With respect to the late neonatal mortality, the states of Maranhão, Piauí, Paraíba and Sergipe showed stationary pattern. The post-neonatal mortality presented the greatest reduction, being highlighted the values of this significant reduction in the states of Alagoas (-8.6) and Pernambuco (-7.6). Considering the entire region, this component showed an APC of -6.1%. At the end of the first decade, post-neonatal mortality showed a stationary pattern over the Northeast region, with the highest values in the states of Maranhão, Ceará, Rio Grande do Norte and Sergipe.

Conclusion

Although it has been a reduction in infant mortality in Northeastern Brazil, the stationary pattern in some states produced reasons for concern, considering that rates are still very elevated when compared to developed areas.

Keywords:
infant mortality; studies of temporal statistical analysis; public health vigilance; ecological studies; epidemiology

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