TENDÊNCIAS DAS TAXAS DE MORTALIDADE DE MENORES DE 5 ANOS DE IDADE POR CAUSAS EVITÁVEIS NO BRASIL E SUAS REGIÕES, 1996-2020

Abstract

Background: The actions of public health coupled with public policies implemented in Brazil over the past decades have contributed to the reduction of infant mortality (IM). Objective: To identify the temporal trends of IM due to preventable causes of death (PCD) in children under 5 years of age in Brazil and its regions from 1996 to 2020. Methods: We analyzed data from the Department of Health Informatics of the Unified Health System (DATASUS) and constructed time series using segmented regression models to identify trends in infant mortality rates (IMR) due to PCD. Results: From 1996 to 2020, there were 1,437,559 preventable deaths in children under five years old in Brazil. The Southeast region recorded the highest percentage (35.80%), followed by the Northeast (33.85%). The study identified overall reductions in IMR due to PCD in Brazil and its regions during the analyzed period, particularly for causes related to immunization, maternal care during pregnancy, maternal care during childbirth, newborn care, proper diagnosis and treatment, and health promotion. Mortality preventable by health promotion actions in primary care showed the smallest declines in Brazil as whole, with a notable emphasis on the Northeast region. However, there was a brief period of rate increases from 2009 to 2014. Conclusion: The results underscore the role of public policies in general, such as the Programa Bolsa Família, and health policies in particular, such as the Programa Nacional de Imunização and the Estratégia Saúde da Família, in reducing preventable child deaths. Despite advancements, challenges and regional inequalities persist, possibly associated with socioeconomic and infrastructural disparities. The integration of intersectoral actions, targeted policies, and periodic evaluations are necessary to address these challenges in order to achieve the goal of eliminating deaths from preventable causes.