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巴西会遵守《2030年议程》的可持续发展目标3.1吗?对1996年至2018年孕产妇死亡率的分析。

Will Brazil comply with the SDG 3.1 of the 2030 Agenda? An analysis of maternal mortality, from 1996 to 2018.

作者信息

Motta Caio Tavares, Moreira Marcelo Rasga

机构信息

Departamento de Ciências Sociais, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1.480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.

出版信息

Cien Saude Colet. 2021 Oct;26(10):4397-4409. doi: 10.1590/1413-812320212610.10752021. Epub 2021 Nov 21.

Abstract

This article aims to analyze if it is possible for Brazil to meet the Sustainable Development Goals (SDG) 3.1, based on a diagnosis of the situation of maternal mortality in the Health Regions (HRs) of Brazil, in 2018, and the main characteristics of this mortality between 1996 and 2018 in the country. The study consists of two articulated phases: (i) bibliographical analysis of maternal mortality in Brazil; (ii) study in the Mortality Information System (SIM, in Portuguese). In 2018, from the 450 HRs, 159 showed a maternal mortality rate (MMR) of above 70 per 100,000 live births (LBs). Between 1996 and 2018, in Brazil, there was a reduction among women 30 to 49 years of age. However, in the age group of 10 to 29 years, there was no change during the time studied. The dissemination of the Maternal Mortality Committees, the PHPN, the PNAISM, and the "Stork Network" have all contributed to improvements in late pregnancies; however, they were inefficient at preventing deaths among young mothers. Compliance with SDG 3.1 requires: prioritization of CIR with MMR greater than 70.0/100,000 LB; qualification of prenatal services, focusing on care among women aged 10 to 29 years and hypertensive complications; and legalization of abortion.

摘要

本文旨在基于对2018年巴西卫生区域孕产妇死亡率状况的诊断以及1996年至2018年该国孕产妇死亡率的主要特征,分析巴西是否有可能实现可持续发展目标3.1。该研究包括两个相互关联的阶段:(i)对巴西孕产妇死亡率的文献分析;(ii)在死亡信息系统(葡萄牙语为SIM)中的研究。2018年,在450个卫生区域中,有159个区域的孕产妇死亡率高于每10万活产70例。1996年至2018年期间,巴西30至49岁女性的死亡率有所下降。然而,在10至29岁年龄组中,在所研究的时间段内没有变化。孕产妇死亡委员会、全国初级卫生保健政策(PHPN)、全国妇幼健康与计划生育政策(PNAISM)以及“鹳网络”的推广都有助于改善晚期妊娠情况;然而,它们在预防年轻母亲死亡方面效率低下。要实现可持续发展目标3.1需要:优先关注孕产妇死亡率高于70.0/10万活产的地区;提升产前服务质量,重点关注10至29岁女性以及高血压并发症;以及将堕胎合法化。

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