Case management and maternal vulnerability evaluation as a strategy to face infant mortality in Brazil: the Paraná example
Abstract
The decline in the infant mortality rate is a Brazilian achievement, but 70% of these deaths are considered avoidable, and the practices of evaluation and monitoring of health policies and programs are still incipient. This research aimed at analyzing the applicability of the Case Management methodology to vulnerable pregnant women in relation to infant mortality. It consisted of a population-based cohort study with secondary data from one Brazilian state in the period from 2008 to 2012. A 95% confidence interval level and minimum significance of p < 0.05 was considered. Maternal variables were considered, representing 1-5% of women who had pregnancies in the period analyzed. The influence of social and historical maternal characteristics on the outcome of deaths in children under one year was evident. The maternal variables: pregnant women under 15 and over 40 years old, pregnant women with a history of dead children and multiple pregnancies, had a higher risk for mortality in children under one year old, configuring a suggestive population for more dedicated prenatal care. Therefore, Case Management in pregnant women is a useful tool in the practice of maternal and child health care.
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