ArticleBMC health services research2019
Can the primary health care model affect the determinants of neonatal, post-neonatal and maternal mortality? A study from Brazil.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- A systematic review of individual and ecological determinants of maternal mortality in the world based on the income level of countries.BMC public health · 2022Pooled it
- Kerala's Aardram Mission and universal health coverage: integrated time series evidence on mortality reduction and assessment of financial protection and equity gaps.Frontiers in public health · 2026Article
- The association between china's primary health care reform and inequalities in primary care utilisation and maternal mortality: a quasi-experimental longitudinal study from 2010 to 2019.International journal for equity in health · 2025Article
- Association of Previne Brasil Program with prenatal care and maternal-child mortality.Revista de saude publica · 2025Observational
- How to Strengthen Primary Care? The Integration of Clinical Practice and Community Health Care.Korean journal of family medicine · 2024Article
- Associations between primary healthcare and infant health outcomes: a cohort analysis of low-income mothers in Rio de Janeiro, Brazil.Lancet regional health. Americas · 2023Article
- Prenatal care and human rights: Addressing the gap between medical and legal frameworks and the experience of women in Brazil.PloS one · 2023Article
- The quality of alternative models of primary health care and morbidity and mortality in Brazil: a national longitudinal analysis.Lancet regional health. Americas · 2021Article
- Article
- Towards neonatal mortality risk classification: A data-driven approach using neonatal, maternal, and social factors.Informatics in medicine unlocked · 2020Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe state of São Paulo recorded a significant reduction in infant mortality from 1990 to 2013, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality (considering the neonatal and post-neonatal dimensions) and maternal mortality in the state of São Paulo, Brazil.
methodsIn this ecological study, data from national official open sources were used to conduct a population-based study. The units analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality (in both neonatal and post-neonatal dimensions) and maternal mortality rates were calculated for every 1000 live births, referring to 2013. Subsequently, the association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. For statistical analysis, we used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted "p" at 5%.
resultsThe increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates.
conclusionsIt was concluded that the Family Health Care Strategy was a Primary Care organization model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model when planning the organization of Primary Care services for the population.
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