Lima Suzanne Santos de, Braga Maria Cynthia, Vanderlei Lygia Carmen de Moraes, Luna Carlos Feitosa, Frias Paulo Germano
Universidade de Pernambuco, Recife, Brasil.
Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil.
Cad Saude Publica. 2020 Feb 21;36(2):e00039719. doi: 10.1590/0102-311X00039719. eCollection 2020.
This study aimed to assess the impact of programs for prenatal, childbirth, and neonatal care (Mother Owl and Stork Network) on avoidable neonatal mortality in Pernambuco State, Brazil, using the adequacy approach. We analyzed the trend in avoidable neonatal mortality and the impact of these programs on avoidable neonatal mortality in four health regions in the state from 2000 to 2016. The Mortality Information System (SIM) and the Information System on Live Births (SINASC) and official documents were used as the data sources. Deaths were classified according to the Brazilian List of Avoidable Causes of Deaths Via Interventions by the Unified National Health System. Linear regression and joinpoint methods were used to analyze tendencies and identifying turning points in the neonatal mortality curves. There was a sharp drop in avoidable neonatal mortality in the state, especially in early neonatal mortality. Except for the I-Recife region, where there was a downturn in the mortality curves after implementation of the Stork Network, there was no association between the turning points in the curves and the periods with the programs' implementation in the regions. Other factors appear to have led to the improvement of these indicators, such as the expansion of the high-risk network. Strengthening this network can thus help reduce avoidable neonatal deaths, especially early deaths.
本研究旨在采用充分性方法评估产前、分娩及新生儿护理项目（猫头鹰妈妈与鹳网络项目）对巴西伯南布哥州可避免的新生儿死亡率的影响。我们分析了该州四个卫生区域2000年至2016年可避免的新生儿死亡率趋势以及这些项目对可避免的新生儿死亡率的影响。死亡率信息系统（SIM）、活产信息系统（SINASC）及官方文件用作数据源。死亡按照巴西《统一国家卫生系统可通过干预避免的死亡原因清单》进行分类。采用线性回归和连接点方法分析新生儿死亡率曲线的趋势并确定转折点。该州可避免的新生儿死亡率大幅下降，尤其是早期新生儿死亡率。除累西腓第一区域在实施鹳网络项目后死亡率曲线出现下降外，曲线转折点与各区域项目实施时期之间并无关联。其他因素似乎导致了这些指标的改善，如高危网络的扩大。因此，加强该网络有助于减少可避免的新生儿死亡，尤其是早期死亡。
