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Neonatal mortality from avoidable causes in the urban network: a spatial analysis, Brazil, 2020-2023
Rivaldo Mauro Faria1, Jean Ezequiel Limongi1
1Universidade Federal de Uberlândia, Instituto de Geografia, Uberlândia, MG, Brazil Universidade Federal de Uberlândia Instituto de Geografia UberlândiaMG Brazil.
Objective:
To analyze spatial variations in the neonatal mortality rate due to avoidable causes within the Brazilian urban and regional network between 2020 and 2023.
Methods:
SA spatial analysis was conducted for Brazilian municipalities using data recorded in the Mortality Information System and the Live Birth Information System. The causes were defined according to the List of avoidable causes of death by interventions of the Brazilian National Health System, and mapped according to the classification of the urban network by the Brazilian Institute of Geography and Statistics. The neonatal mortality rate due to avoidable causes was estimated using the empirical Bayesian method. Analyses were performed using spatial autocorrelation techniques, through local and global Moran's indices.
Results:
A total of 65,183 neonatal deaths due to selected avoidable causes were recorded. Higher rates were found in the North (7.5 per 1,000 live births) and Northeast (7.0 per 1,000 live births) regions, while lower rates were observed in the South (4.9 per 1,000 live births) and Southeast (5.7 per 1,000 live births) regions. Rates were higher in local centers of the North (7.9 per 1,000 live births) and lower in the metropolises of the South (4.4 per 1,000 live births). Attention to women during pregnancy was the main avoidable cause (37.3%), followed by newborn attention (21.7%) and attention during childbirth (13.2%). The global Moran's index indicated spatial dependence of 0.240 (p-value 0.001).
Conclusion:
Spatial inequalities were observed in the neonatal mortality rate due to avoidable causes, with notably higher rates in local centers of the North and Northeast regions, indicating the need for preventive actions during pregnancy, childbirth, and newborn care.
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