Revista Brasileira de Epidemiologia
Print version ISSN 1415-790X
VICTORA, Cesar G.. Potential interventions to improve the health of mothers and children in Brazil. Rev. bras. epidemiol. [online]. 2001, vol.4, n.1, pp.3-69. ISSN 1415-790X. http://dx.doi.org/10.1590/S1415-790X2001000100002.
This review was aimed at analyzing the potential impact of interventions to reduce maternal and child mortality in Brazil. A combination of direct and indirect demographic methods was used to describe time trends, regional variations and cause-specific distribution of mortality. Current coverage levels of preventive interventions were also assessed. Based on these parameters, as well as on a review of the international literature on the effectiveness of different interventions, the latter were ranked according to their potential impact. Child mortality levels are falling, but current rates are still high and there are major regional differences, with the highest rates observed in the Northeastern and Northern Regions. Due to the predominance of perinatal causes in underfive child mortality, the most promising interventions include improving the quality and coverage of antenatal and delivery care, followed by the integrated management of infectious diseases and nutritional counseling. Improvement in antenatal and delivery care will also contribute to reducing maternal mortality. It is also important to ensure the sustainability of current achievements, including vaccine coverage, oral rehydration therapy and family planning, as well as to invest heavily in reducing major regional differences.
Keywords : Infant mortality, trends; Maternal mortality, trends; Primary prevention; Prenatal care; Perinatal care; Equity in access; Health promotion; Epidemiology; Brazil.