Recent trends in maternal, newborn, and child health in Brazil: progress toward Millennium Development Goals 4 and 5

Abstract

We analyzed Brazil's efforts in reducing child mortality, improving maternal and child health, and reducing socioeconomic and regional inequalities from 1990 through 2007. We compiled and reanalyzed data from several sources, including vital statistics and population-based surveys. We also explored the roles of broad socioeconomic and demographic changes and the introduction of health sector and other reform measures in explaining the improvements observed. Our findings provide compelling evidence that proactive measures to reduce health disparities accompanied by socioeconomic progress can result in measurable improvements in the health of children and mothers in a relatively short interval. Our analysis of Brazil's successes and remaining challenges to reach and surpass Millennium Development Goals 4 and 5 can provide important lessons for other low- and middle-income countries.

FIGURE 1

Trends in infant, neonatal, and postneonatal mortality rates: Brazil, 1990–2007.

FIGURE 2

Trends in infant mortality rates, by region: Brazil, 1990–2007.

FIGURE 3

Trends in cause-specific infant mortality rates: Brazil, 1990–2007.

FIGURE 4

Time trends in selected coverage indicators, by survey year: Brazil, 1996–2007. Note. ARI = acute respiratory infection; DPT = diphtheria–pertussis–tetanus. Data are from the 1996 Demographic and Health Survey and a similar survey (Pesquisa Nacional sobre Demografia e Saúde) carried out by the Ministry of Health in 2006–2007.

FIGURE 5

Mortality rates among Brazilian infants and children aged younger than 5 years, by survey year and wealth quintile: Brazil, 1996–2007. Note. Data are shown from the 1996 Demographic and Health Survey and a similar survey (Pesquisa Nacional sobre Demografia e Saúde) carried out by the Ministry of Health in 2006–2007. Both surveys refer to the 10 years prior to the survey administration. Thus, estimates based on the 1996 survey refer to the period 1987 through 1996 and have a midpoint at 1991, and estimates based on the 2006–2007 have at midpoint at 2001–2002. Estimates were calculated by the authors.