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Salud materna e infantil en Brasil: progresos y desafíos
Cesar G Victora1, Estela M L Aquino, Maria do Carmo Leal
1Post-Graduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. cvictora@gmail.com
Lancet (London, England)
|May 13, 2011
Resumen
Brasil ha mejorado significativamente la salud y la nutrición infantil en los últimos 30 años, con una reducción de la mortalidad infantil y el retraso en el crecimiento. Los factores clave incluyen cambios socioeconómicos, programas de salud pública y un servicio nacional de salud, aunque persisten desafíos como la medicalización excesiva.
Área de la Ciencia:
- Salud Pública y Servicios de Salud Investigación Investigación.
- Salud Materna y Infantil.
- Equidad en salud y determinantes sociales de la salud.
Sus antecedentes:
- Brasil experimentó grandes cambios en los determinantes sociales de la salud y la organización de servicios de salud en las últimas tres décadas.
- Estos cambios afectaron significativamente la salud materna, la salud infantil y los indicadores de nutrición infantil.
- Comprender estos impactos es crucial para las políticas e intervenciones de salud basadas en la evidencia.
Objetivo del estudio:
- Examinar los efectos de los cambios socioeconómicos y del sistema de salud en los indicadores de salud materna e infantil en Brasil.
- Para analizar las tendencias en la mortalidad infantil, el retraso del crecimiento infantil y el acceso a las intervenciones de salud.
- Identificar los factores que contribuyen al progreso de Brasil y los desafíos restantes en la salud materna e infantil.
Principales métodos:
- Utilizó datos de estadísticas vitales, censos de población, encuestas demográficas y de salud, e informes publicados.
- Se analizaron las tendencias en las tasas de mortalidad infantil, las muertes neonatales y la prevalencia de retraso en el crecimiento en niños menores de cinco años.
- Evaluar los cambios en el acceso a las intervenciones de salud materna e infantil y la duración de la lactancia materna.
Principales resultados:
- Reducción sustancial de las tasas de mortalidad infantil (5,5% anual en las décadas de 1980 y 1990, 4,4% desde 2000) y la prevalencia de retraso en el crecimiento (del 37% al 7%).
- Aumento significativo en el acceso a las intervenciones de salud materna e infantil, acercándose a la cobertura universal, con desigualdades reducidas.
- Las tasas de mortalidad materna muestran estabilidad en los datos oficiales, pero los datos modelados sugieren una disminución anual del 4%, potencialmente enmascarada por la mejora de los informes.
Conclusiones:
- Brasil logró mejoras significativas en la salud y nutrición infantil a través de cambios socioeconómicos, programas de salud específicos y un servicio nacional de salud.
- El progreso se atribuye al crecimiento económico, la reducción de las disparidades de ingresos, la mejora de la educación, la ampliación de la cobertura de salud a través del Programa de Salud Familiar y las acciones intersectoriales.
- Los desafíos persistentes incluyen la medicalización excesiva del parto, las muertes maternas por abortos ilegales y las altas tasas de partos prematuros.
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