Impact of the Family Health Program on Infant Mortality in Brazilian Municipalities
Impact of the Family Health Program on Infant Mortality in Brazilian Municipalities
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DOI：
10.2105/ajph.2007.127480
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发表时间：
2009-01-01
影响因子：
12.7
通讯作者：
Barreto, Mauricio L.
中科院分区：
文献类型：
--
作者：
Aquino, Rosana;de Oliveira, Nelson F.;Barreto, Mauricio L.
目标。我们评估了家庭健康计划（FHP）对城市一级婴儿死亡率的影响，FHP是巴西全国一级初级卫生保健重组战略。我们收集了1996年至2004年巴西5561个城市中771个城市FHP覆盖率和婴儿死亡率的数据。我们使用固定效应模型对具有负二项反应的面板数据进行了多变量回归分析，该模型控制了人口统计、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，在FHP覆盖率的3个水平上，婴儿死亡率分别降低了13.0%、16.0%和22.0%。在研究期开始时，在婴儿死亡率较高和人类发展指数较低的城市，FHP的效果更大。1996年至2004年，计划生育方案在降低巴西各城市的婴儿死亡率方面发挥了重要作用。FHP也可能有助于减少保健不平等。[J] .公共卫生，2008;99:87-93。doi: 10.2105 / AJPH.2007.127480)
Objectives. 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.Methods. 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.Results. 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.Conclusions. 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. (Am J Public Health. 2008;99:87-93. doi: 10.2105/AJPH.2007.127480)