巴西卫生协定的执行情况:它给儿童死亡率带来了哪些变化?

Talita Araujo Souza, F. B. Andrade
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引用次数: 0

摘要

这项研究的目的是验证社会不平等与婴儿死亡率之间的关系,从而推断巴西在执行《生命公约》后发生了什么变化。以1996 - 2016年为时间序列,通过死亡率信息系统进行具有空间相关性的流行病学生态学研究。为了开发和分析数据,我们考虑了161个城市衔接的中间区域。研究年份的婴儿死亡率系数为因变量,选择人类发展指数、基尼系数、贫困人口百分比和家庭补助计划覆盖率作为自变量。描述性数据在社会科学统计包中进行了分析。使用Geoda软件对死亡率数据进行空间化,以确定双变量空间自相关性。结果表明,在过去几十年中,婴儿死亡率有所下降;空间自相关表现为前10年东北地区系数较高,后10年北部和中西部地区系数较高。在人类发展指数与婴儿死亡率系数的双变量分析中,东南、南部和中西部地区在20年内表现出较大的自相关性;在基尼系数上,前10年北方和东北呈现自相关,后10年北方、东北和中西部呈现自相关。当与贫困进行评估时,在北部和东北部观察到自相关;随着家庭补助计划的覆盖,自相关性集中在东北部。即使在《生命公约》发表前后,社会不平等也与婴儿死亡率有直接关系。《公约》有一项指标是降低婴儿死亡率,但孤立地加以评价是有效的,尽管这一问题有所减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementation of the pact for health in Brazil: what changes did it bring to child mortality?
This study aimed to verify the association of social inequalities with infant mortality rate so as to infer what has changed in Brazil with the implementation of the Pact for Life. This was an epidemiological ecological study of the time series type with spatial correlation carried out through the Mortality Information System, considering the years from 1996 to 2016. For the development and analysis of the data, the 161 Intermediate Regions of Urban Articulation were considered. The infant mortality coefficient in the years studied was the dependent variable, and as independent variables, the ones selected were the Human Development Index, Gini Index, percentage of poor people and the coverage of the Family Grant Program. Descriptive data were analyzed in the Statistical Package for the Social Sciences. Mortality data were spatialized to determine bivariate spatial autocorrelations using the Geoda software. It was identified in the results that there was a decrease in the infant mortality rate in the decades; spatial autocorrelation showed high coefficients in the Northeast in the first decade, and higher coefficients in the North and Midwest in the second decade. In the bivariate analysis of the infant mortality coefficient with the Human Development Index, greater autocorrelation was observed in the Southeast, South and Midwest regions in the two decades; with the Gini index, the first decade showed autocorrelation in the North and Northeast, and in the second decade, there was autocorrelation in the North, Northeast, and Midwest. When assessed with poverty, autocorrelation was observed in the North and Northeast; and with coverage of the Family Grant Program, autocorrelation was concentrated in the Northeast. Even before and after the release of the Pact for Life, social inequalities were directly related to infant mortality. The Pact, which had one of its indicators the reduction in infant mortality, was effective when evaluated in isolation, however, despite the decrease in this problem.
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