TWENTY YEARS EVOLUTION OF CHILD HEALTH INEQUITIES IN THE NORTH-EASTERN REGION OF BRAZIL: A TIME SERIES ANALYSIS

Tuesday, 19 August 2014
Exhibit hall (Dena'ina Center)
Luciano Lima Correia, PhD , Federal University of Ceará, Fortaleza, Brazil
Hermano A Lima Rocha, MD , Federal University of Ceará, Fortaleza, Brazil
Márcia M Tavares Machado, PhD , Federal University of Ceará, Fortaleza, Brazil
Anamaria C Silva, PhD , Christus Faculty, Fortaleza, Brazil
Jocileide S Campos, MD , Christus Faculty, Fortaleza, Brazil
Ana C Lindsay, PhD , University of Massachusetts Boston, Boston, MA
Antônio J Ledo Alves da Cunha, PhD , Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
INTRODUCTION:  There is considerable concern on child health inequities in Brazil, being essential to identify among the poor, those more in need. The study aimed to analyze how child health equity has evolved in the poorest semi-arid region of Brazil, in a period of 20 years.

METHODS:  A series of 5 surveys on mother and child health were carried out in the State of Ceará, utilizing cluster random samplings of 8,000 households. Prevalence of morbidities, use of health services and malnutrition on children below 3 years old were calculated for the years of 1987 and 2007, according to quintiles of monthly family income. General linear models with polynomial contrast tests were applied for statistical significance.

RESULTS: In 1987, inequality was markedly present for all indicators of child nutrition and health care access and coverage analyzed, as families of the 1st. quintile of monthly income performed significantly worse than families of the subsequent quintiles (p<0.001). In 2007, there was a clear improvement in the equity related to access to child health care, with no significant difference being observed among the quintiles of income. Prevalence of child malnutrition, however, increased gradually, as the monthly family income deteriorated, as already observed in 1987. 

CONCLUSIONS: There was outstand improvement in the equity related to child health care access and coverage in the poorest semi-arid region of Brazil, in the 20 years span. For child malnutrition, however, although there was a sharp decline in the prevalence rates, the inequity persists, with the poorest families still been significantly more affected.