Trends in avoidable causes of infant mortality in Belo Horizonte, Brazil, 1984 to 1998

OBJECTIVE: To analyze the infant mortality trend in a metropolitan area, from 1984 to 1998. The main focus was on avoidable causes of neonatal and post-neonatal mortality. METHODS: Sources of data were the Sistema de Informacoes em Mortalidade do Ministerio da Saude (SIM-MS) Mortality Information System of the Ministry of Health] and Fundacao Instituto Brasileiro de Geografia e Estatistica (IBGE) Brazilian Institute of Geography and Statistics Foundation] (official live birth and death records) for the metropolitan region of Belo Horizonte, in the State of Minas Gerais. A simple linear regression model was used to evaluate time-trends of mortality rates. Statistical significance of the inclination of the regression curves was considered for the p<0.05 level. RESULTS: During the 15 year period in question, the infant mortality rate declined from 48.5 to 22.1/1,000 live births. However, the most accentuated decrease was observed during the last four years of the study period. The post-neonatal group was greatly responsible for this decline both in the capital and in the other districts within the metropolitan region of Belo Horizonte. CONCLUSIONS: Although a significant decrease in the infant mortality rate has been observed, particularly in the post-neonatal mortality, it is still larger than the rates found in developed countries. Deaths due to perinatal morbidities as well as the group of causes represented by diarrhea-pneumonia-malnutrition still present an important potential for reduction. The authors discuss the role of the health services in improving the rates of these avoidable causes of infant mortality.