Figueirôa Barbara de Queiroz, Lira Pedro Israel Cabral de, Vanderlei Lygia Carmen de Moraes, Vidal Suely Arruda, Frias Paulo Germano de
Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal de Pernambuco, Recife, Brasil.
Secretaria Estadual de Saúde de Pernambuco, Recife, Brasil.
Cad Saude Publica. 2024 Jan 8;40(1):e00077523. doi: 10.1590/0102-311XPT077523. eCollection 2024.
This study evaluated the influence of the variation in the implementation of the Brazilian Mortality Information System (SIM) on the results, before and after the intervention to improve the system in Pernambuco, Brazil. The SIM logical model and matrix of indicators and assessment were described, primary data were collected from the 184 municipalities and secondary data were collected from the system database. The degree of implementation (DI) was obtained from the indicators of structure and process, and then related to result indicators, based on the model. The intervention was directed at the shortcomings identified, and developed using strategic stages. The percentage of annual variation of the DI and the results before and after the intervention were calculated. The SIM was classified as partially implemented in the pre- (70.6%) and post-intervention (73.1%) evaluations, with increments in all components. The Health Regions followed the same classification of the state level, except for XII (80.3%), regarding implemented score after the intervention. The coverage of the system; deaths with a defined underlying cause; monthly transfer; and timely submission of data were above 90% in both evaluations. There was an improvement in the completeness of infant Death Certificates and in the timely recording of notifiable events. Strengthening the management and operationalization of the SIM with interventions applied to data registration can improve the system's results.
本研究评估了巴西死亡率信息系统(SIM)实施情况的变化对巴西伯南布哥州改善该系统干预前后结果的影响。描述了SIM的逻辑模型、指标矩阵和评估方法,从184个市收集了原始数据,并从系统数据库收集了二手数据。根据该模型,从结构和过程指标中得出实施程度(DI),然后将其与结果指标相关联。针对所发现的不足进行干预,并分战略阶段开展。计算了干预前后DI和结果的年度变化百分比。在干预前(70.6%)和干预后(73.1%)的评估中,SIM被归类为部分实施,所有组成部分均有增加。除第十二卫生区(80.3%)外,各卫生区在干预后的实施得分与州级分类相同。在两次评估中,该系统的覆盖率、有明确根本死因的死亡人数、月度数据传输以及数据的及时提交率均高于90%。婴儿死亡证明的完整性和应报告事件的及时记录有所改善。通过对数据登记应用干预措施来加强SIM的管理和运作,可以改善该系统的结果。