Block 1 - Socioeconomic conditions and access to health services |
MHDI |
Dimensions of the Global HDI (longevity, education, and income), adapting the methodology to the Brazilian context and the availability of national indicators. |
Atlas Brasil |
0.00-0.499=very low; 0.500-0.599=low; 0.600-0.699=medium; 0.700-0.799=high; 0.800-1.00=very high1818. Programa das Nações Unidas para o Desenvolvimento. Instituto de Pesquisa Econômica Aplicada. Fundação João Pinheiro. Atlas do desenvolvimento humano no Brasil [Internet]. [acessado em 17 ago. 2023]. Disponível em: Disponível em: http://www.atlasbrasil.org.br http://www.atlasbrasil.org.br...
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Percentage of LB according to mother’s age range |
Number of LB by maternal age divided by total LB and multiplied by 100. |
SINASC |
National average |
Percentage of LB according to mother’s race/color |
Number of LB by maternal skin color divided by total LB and multiplied by 100. |
SINASC |
National average |
Percentage of LB according to mother’s education |
Number of LB by maternal education divided by total LB and multiplied by 100. |
SINASC |
National average |
Percentage of women aged 10 to 49 years who are exclusive users of SUS |
(Female population aged 10 to 49 years minus female population aged 10 to 49 years benefiting from medical insurance) divided by the female population aged 10 to 49 years and multiplied by 100. |
ANS, IBGE |
National average |
Population coverage with family health teams |
Annual average of the population assisted by family health teams divided by the total population of the municipality and multiplied by 100. |
SIAB |
95% (SDG)*1111. Instituto de Pesquisa Econômica Aplicada. Objetivos de Desenvolvimento Sustentável. Saúde e bem-estar [Internet]. [acessado em 26 dez. 2022]. Disponível em: Disponível em: https://www.ipea.gov.br/ods/ods3.html https://www.ipea.gov.br/ods/ods3.html...
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Block 2 - Reproductive planning |
Specific fertility rate in women under 20 years of age |
Number of LB of women under 20 years old divided by the female population aged 10 to 19 years old and multiplied by 1,000. |
SINASC, IBGE |
<30 per 1,000 (developed countries)1515. Fundo de População das Nações Unidas. Fecundidade e dinâmica da população brasileira [Internet]. Brasília: UNFPA; 2018 [acessado em 7 jul. 2022]. Disponível em: Disponível em: https://brazil.unfpa.org/pt-br/publications/fecundidade-e-dinamica-da-populacao-brasileira-folder https://brazil.unfpa.org/pt-br/publicati...
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Percentage of multiparous women |
Number of LB of women with >3 previous births divided by total LB and multiplied by 100. |
SINASC |
National average |
Unsafe abortion rate per 1,000 women of childbearing age1919. Singh S, Prada E, Juarez F. The abortion incidence complications method: a quantitative technique. In: Singh S, Remez L, Tartaglione A, eds. Methodologies for estimating abortion incidence and abortion-related morbidity: a review [Internet]. New York: Guttmacher Institute; 2010. p. 71-98. [acessado em 12 jan. 2023]. Disponível em: Disponível em: https://www.guttmacher.org/sites/default/files/pdfs/pubs/compilations/IUSSP/IUSSP-Chapter6.pdf https://www.guttmacher.org/sites/default...
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Number of hospitalizations for abortion in public and private services multiplied by the correction factor for hospitalizations for spontaneous abortion and for induced abortions without hospital admission divided by the female population aged 10 to 49 years and multiplied by 1,000. |
SIH/SUS, ANS, IBGE |
National average |
Unsafe abortion ratio per 100 LB1919. Singh S, Prada E, Juarez F. The abortion incidence complications method: a quantitative technique. In: Singh S, Remez L, Tartaglione A, eds. Methodologies for estimating abortion incidence and abortion-related morbidity: a review [Internet]. New York: Guttmacher Institute; 2010. p. 71-98. [acessado em 12 jan. 2023]. Disponível em: Disponível em: https://www.guttmacher.org/sites/default/files/pdfs/pubs/compilations/IUSSP/IUSSP-Chapter6.pdf https://www.guttmacher.org/sites/default...
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Number of hospitalizations for abortion in public and private services multiplied by the correction factor for hospitalizations for spontaneous abortion and for induced abortions without hospital admission divided by total LB and multiplied by 100. |
SIH/SUS, ANS, SINASC |
National average |
Block 3 - Prenatal care |
Prenatal care coverage |
Number of LB of mothers with any prenatal consultation divided by total LB and multiplied by 100. |
SINASC |
95% (WHO recommendation)†99. World Health Organization. Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus. Genebra: World Health Organization; 2021. |
Percentage of women starting early prenatal care |
Number of LB of mothers who started prenatal care in the first trimester of pregnancy divided by total LB and multiplied by 100. |
SINASC |
95% (WHO recommendation)†99. World Health Organization. Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus. Genebra: World Health Organization; 2021. |
Percentage of women with more than seven prenatal consultations |
Number of LB of mothers with >7 prenatal consultations divided by total LB and multiplied by 100. |
SINASC |
95% (WHO recommendation)†99. World Health Organization. Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus. Genebra: World Health Organization; 2021.,1212. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Genebra: World Health Organization; 2016. |
CS incidence rate |
Number of CS cases in <1 year divided by total LB and multiplied by 1,000. |
SINAN, SINASC |
≤0.5 per 1 thousand LB (international goal)99. World Health Organization. Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus. Genebra: World Health Organization; 2021. |
Block 4 - Delivery assistance |
Percentage of births by cesarean section |
Number of LB per cesarean section divided by total LB and multiplied by 100. |
SINASC |
10-15% (WHO reference)1313. World Health Organization. WHO statement on caesarean section rates. Genebra: World Health Organization; 2015. |
Percentage of births according to Robson group |
Number of LB per Robson group divided by total LB and multiplied by 100. |
SINASC |
National average |
Percentage of births by cesarean section in each Robson group |
Number of LB by cesarean section in each Robson group divided by total LB in each Robson group and multiplied by 100. |
SINASC |
Group 1=10%; Group 2=20 to 35%; Group 3=3%; Group 4=15%; Group 5=50 to 60%; Group 10=30% (WHO reference)1414. World Health Organization. WHO Robson classification: implementation manual. Genebra: World Health Organization; 2017.; Groups 6 to 9=national average. |
Relative contribution of each Robson group to the total cesarean section rate |
Number of LB by cesarean section in each Robson group divided by total LB per cesarean section and multiplied by 100. |
SINASC |
National average |
Percentage of births according to place of occurrence |
Number of LB per birth location divided by total LB and multiplied by 100. |
SINASC, CNES |
National average of births occurring in the municipality of residence |
Median travel for births occurring outside the mother's municipality of residence according to complexity of the birth care service |
Median travel in kilometers between the geographic coordinate of the urban perimeter of the mother’s municipality of residence and that of the municipality in which the birth occurred. Complexity of the service defined according to adult ICU bed availability registered in CNES. |
SINASC, CNES |
No reference standard‡
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Block 5 - Birth conditions |
Percentage of births with low birth weight |
Number of LB with birth weight <2,500 g divided by total LB and multiplied by 100. |
SINASC |
30% reduction by 2025 in relation to values observed in 2006-2010 (international goal)1010. World Health Organization. Comprehensive implementation plan on maternal, infant and young child nutrition. Genebra: World Health Organization; 2012. |
Percentage of preterm births |
Number of LB with GA <37 weeks divided by total LB and multiplied by 100. |
SINASC |
10% (developed countries)1616. Chawanpaiboon S, Vogel JP, Mole AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health 2019; 7(1): e37-e46. https://doi.org/10.1016/S2214-109X(18)30451-0 https://doi.org/10.1016/S2214-109X(18)30...
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Percentage of early term births |
Number of LB with GA 37 or 38 weeks divided by the total LB and multiplied by 100. |
SINASC |
20% (developed countries with a low percentage of cesarean births)1717. Richards JL, Kramer MS, Deb-Rinker P, Rouleau J, Mortensen L, Gissler M, et al. Temporal trends in late preterm and early term birth rates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions. JAMA 2016; 316(4): 410-9. https://doi.org/10.1001/jama.2016.9635 https://doi.org/10.1001/jama.2016.9635...
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Block 6 - Maternal mortality and morbidity |
Number of maternal deaths |
Total number of maternal deaths after investigation. |
SIM |
No reference standard§
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MMR |
Number of maternal deaths divided by total LB multiplied by 100,000. |
SIM, SINASC |
<30 per 100,000 live births (Brazil SDG)1111. Instituto de Pesquisa Econômica Aplicada. Objetivos de Desenvolvimento Sustentável. Saúde e bem-estar [Internet]. [acessado em 26 dez. 2022]. Disponível em: Disponível em: https://www.ipea.gov.br/ods/ods3.html https://www.ipea.gov.br/ods/ods3.html...
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Percentage of maternal deaths due to direct obstetric causes |
Number of maternal deaths from direct obstetric causes divided by the total number of maternal deaths multiplied by 100. |
SIM |
National average |
Percentage of direct maternal deaths due to specific causes |
Number of maternal deaths from specific direct obstetric causes (abortion, hypertension, hemorrhage, and infections) divided by the total number of maternal deaths from direct obstetric causes multiplied by 100. |
SIM |
National average |
Percentage of obstetric hospitalizations classified as severe maternal morbidity |
Number of SMM cases divided by the total number of public obstetric hospitalizations multiplied by 100 |
SIH/SUS |
National average |
Percentage of cases of severe maternal morbidity according to specific causes |
Number of SMM cases according to cause (hypertension, hemorrhage, infection) divided by the total number of SMM cases in public obstetric hospitalizations multiplied by 100. |
SIH/SUS |
National average |
Percentage of SMM cases according to management indicators |
Number of SMM cases according to management indicator (transfusion, surgery, ICU admission, ALS >7 days) divided by the total of SMM cases in public obstetric hospitalizations multiplied by 100. |
SIH/SUS |
National average |
Quality of information |
SINASC Coverage |
Number of LB in SINASC divided by the estimated number of births multiplied by 100. |
IBGE |
90%77. Szwarcwald CL, Leal MC, Esteves-Pereira AP, Almeida WS, Frias PG, Damacena GN, et al. Avaliação das informações do Sistema de Informações sobre Nascidos Vivos (SINASC), Brasil. Cad Saúde Pública 2019; 35(10): e00214918. https://doi.org/10.1590/0102-311X00214918 https://doi.org/10.1590/0102-311X0021491...
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SIM coverage |
Number of deaths in SIM divided by the estimated number of deaths multiplied by 100. |
IBGE |
90%77. Szwarcwald CL, Leal MC, Esteves-Pereira AP, Almeida WS, Frias PG, Damacena GN, et al. Avaliação das informações do Sistema de Informações sobre Nascidos Vivos (SINASC), Brasil. Cad Saúde Pública 2019; 35(10): e00214918. https://doi.org/10.1590/0102-311X00214918 https://doi.org/10.1590/0102-311X0021491...
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Percentage of deaths of women of childbearing age investigated |
Number of WCA deaths investigated divided by total WCA deaths and multiplied by 100. |
Tabnet SIM |
90% (national goal)2020. Governo do Pará. Secretaria de Estado de Saúde Pública. Núcleo de Informações em Saúde e Planejamento. Pactuação interfederativa 2020-2023. Ficha de indicadores. Consolidado com 52 indicadores nacional/estadual [Internet]. 2019 [acessado em 17 ago. 2023]. Disponível em: Disponível em: http://www.saude.pa.gov.br/wp-content/uploads/2021/06/Pactuacao-Interfederativa-2020-2023.pdf . http://www.saude.pa.gov.br/wp-content/up...
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Percentage of maternal deaths investigated |
Number of maternal deaths investigated divided by the total number of maternal deaths and multiplied by 100. |
Tabnet SIM |
100% (national goal)2020. Governo do Pará. Secretaria de Estado de Saúde Pública. Núcleo de Informações em Saúde e Planejamento. Pactuação interfederativa 2020-2023. Ficha de indicadores. Consolidado com 52 indicadores nacional/estadual [Internet]. 2019 [acessado em 17 ago. 2023]. Disponível em: Disponível em: http://www.saude.pa.gov.br/wp-content/uploads/2021/06/Pactuacao-Interfederativa-2020-2023.pdf . http://www.saude.pa.gov.br/wp-content/up...
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Degree of incompleteness |
Number of variables with blank or missing records divided by total LB and multiplied by 100. |
SINASC |
<5%88. Romero DE, Cunha CB. Avaliação da qualidade das variáveis sócio-econômicas e demográficas dos óbitos de crianças menores de um ano registrados no Sistema de Informações sobre Mortalidade do Brasil (1996/2001). Cad Saúde Pública 2006; 22(3): 673-81. https://doi.org/10.1590/s0102-311x2006000300022 https://doi.org/10.1590/s0102-311x200600...
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