Going to scale with community-based primary care: An analysis of the family health program and infant mortality in Brazil, 1999-2004
Going to scale with community-based primary care: An analysis of the family health program and infant mortality in Brazil, 1999-2004
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DOI：
10.1016/j.socscimed.2007.06.028
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发表时间：
2007-11-01
影响因子：
5.4
通讯作者：
Simoes, Celso Cardoso da Silva
中科院分区：
文献类型：
--
作者：
Macinko, James;de Souza, Maria de Fatima Marinho;Simoes, Celso Cardoso da Silva
本文评估了1999年至2004年，综合性社区初级保健计划（巴西家庭健康计划，简称PSF）对婴儿死亡率（IMR）、新生儿死亡率和新生儿后期死亡率的微区域变化的影响。这项研究利用了一个汇集的横断面生态分析，使用来自巴西小区域的面板数据，并控制了每1000人的医生和医院床位，B型肝炎覆盖率，没有产前护理和没有受过正规教育的妇女比例，低出生体重儿，人口规模和贫困率。这些数据涵盖了巴西所有557个小区6年期间（1999-2004年）的情况。结果表明，婴儿死亡率从1999年到2004年下降了约13%，而家庭保健方案的覆盖率从平均约14%增加到近60%。控制其他健康决定因素，家庭健康计划覆盖率增加10%，婴儿死亡率下降0.45%，新生儿后期死亡率下降0.6%，腹泻死亡率下降1%（p
This article assesses the effects of an integrated community-based primary care program (Brazil's Family Health Program, known as the PSF) on microregional variations in infant mortality (IMR), neonatal mortality, and post-neonatal mortality rates from 1999 to 2004. The study utilized a pooled cross-sectional ecological analysis using panel data from Brazilian microregions, and controlled for measures of physicians and hospital beds per 1000 population, Hepatitis B coverage, the proportion of women without prenatal care and with no formal education, low birth weight births, population size, and poverty rates. The data covered all the 557 Brazilian microregions over a 6-year period (1999-2004). Results show that IMR declined about 13 percent from 1999 to 2004, while Family Health Program coverage increased from an average of about 14 to nearly 60 percent. Controlling for other health determinants, a 10 percent increase in Family Health Program coverage was associated with a 0.45 percent decrease in IMR, a 0.6 percent decline in post-neonatal mortality, and 1 percent decline in diarrhea mortality (p