After the progress, child mortality rises and illnesses return

BRASÍLIA – The path of infant mortality in Brazil is indicated as a clear example that progress in the field of health care is far from irreversible. After 25 years of deterioration, Brazil recorded the first increase in mortality rates among children under one year in 2016. There were 14 deaths per thousand live births, 5% more than in the previous year.

Initially attributed to reduced births due to zika, the mortality rate also increased in 2017. Preliminary data show that 13.6 deaths per thousand live births. "The epidemic has not explained the phenomenon for two years in a row, there is probably a tendency to increase," says the professor at the Federal University of Pelotas, Cesar Victora.

Poor population more susceptible

The researcher partly attributes the recovery of mortality figures to setbacks in areas that are known to affect health quality, such as employment, income and equality in access. "The population is poorer, more susceptible," says the professor. Not only are these factors inadequate, but investments in public health also endanger the quality of health care – even programs focused on specific problems, whether they are immunization, breastfeeding or basic child health care.

"The deaths from diarrhea have increased again and the immunization program, which has always been a source of pride, has also begun to show signs of regression, with high rates of unprotected children." Another initiative that is considered an example of the country, the breastfeeding program, is also stagnating. "There have been some very important progress, but since 2013 the exclusive breastfeed percentages have been parked low." Currently, 40% of babies have been breastfed for 6 months. The ideal would be 100%. When breastfed, the baby grows with better protection against infections, for example.

For Victora, it is essential to work on improving the quality of care. "That is one of the challenges." And this also applies to helping pregnant women. Just as with infant mortality, maternal mortality (during pregnancy and up to 42 days postpartum) was also considered high: 64.4 per 100,000 live births. "To reduce them, we need to address the discussion about the liberation of abortion, improve prenatal care and reduce the delivery of cesarean sections."

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