Aquino Rosana, de Oliveira Nelson F, Barreto Mauricio L
Instituto de Saúde Coletiva, Federal University of Bahia, Rua Basílio da Gas/n, Canela, CEP. 40.110-140. Salvador, Bahia, Brazil.
Am J Public Health. 2009 Jan;99(1):87-93. doi: 10.2105/AJPH.2007.127480. Epub 2008 Nov 13.
We evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level.
We collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. We performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables.
We observed a statistically significant negative association between FHP coverage and infant mortality rate. After we controlled for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period.
The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities.
我们评估了巴西全国范围内初级卫生保健重组战略——家庭健康计划（FHP）对市一级婴儿死亡率的影响。
我们收集了1996年至2004年巴西5561个市中771个市的FHP覆盖率和婴儿死亡率数据。我们使用固定效应模型对面板数据进行了负二项式响应的多变量回归分析，该模型控制了人口、社会和经济变量。
我们观察到FHP覆盖率与婴儿死亡率之间存在统计学上显著的负相关。在我们控制了潜在的混杂因素后，FHP覆盖率的三个水平对应的婴儿死亡率分别降低了13.0%、16.0%和22.0%。在研究期开始时，婴儿死亡率较高且人类发展指数较低的市，FHP的效果更大。
1996年至2004年期间，FHP对降低巴西各市的婴儿死亡率有重要影响。FHP也可能有助于减少健康不平等。
