Trend of infant mortality in cities of metropolitan region of Porto Alegre, Brazil from 1996 to 2021

Stahnke, Douglas Nunes; Agranonik, Marilyn; Costa, Juvenal Soares Dias da

doi:10.1590/1413-812320242911.16642023

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THEMATIC ARTICLE • Ciênc. saúde coletiva 30 (suppl 1) • 2025 • https://doi.org/10.1590/1413-812320242911.16642023EN linkcopy

Trend of infant mortality in cities of metropolitan region of Porto Alegre, Brazil from 1996 to 2021

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim is to verify the trend in infant mortality (IM) and preventable infant mortality (PIM) in municipalities in the metropolitan region of Porto Alegre from 1996 to 2021 and their associations with per capita public spending on health and population coverage of the Family Health Strategy (FHS). Ecological study with data from information systems: on mortality, live births, public budgets and primary health care. The deaths described in the Ministry of Health's list were considered preventable. Statistical analysis used Prais-Winsten regression. A decrease in MIE was observed in the municipalities studied with the exception of Esteio. There was an association between per capita public spending on health and the study outcomes in Novo Hamburgo, Canoas and Porto Alegre. An association was found between the FHS coverage and IM in Novo Hamburgo, Sapucaia do Sul, Canoas and Porto Alegre. PIM was associated with FHS coverage in Novo Hamburgo, Canoas and Porto Alegre. Despite the decrease in the IM and PIM coefficients, the association of this indicator was more impacted by per capita public spending on health than by the FHS population coverage.

Keywords:
Infant Mortality; Causes of death; Healthcare Financing; Public Expenditures on Health; Family Health Strategy

Year	Novo Hamburgo		São Leopoldo		Sapucaia do Sul		Esteio		Canoas		Porto Alegre
Year	IM	NM (%)	IM	NM (%)	IM	NM (%)	IM	NM (%)	IM	NM (%)	IM	NM (%)
1996	19.6	67.5	18.3	60.8	16.9	60.5	9.9	72.2	21.9	55.5	18.5	52.6
1997	15.9	65.2	11.8	59.6	13.5	78.8	15.0	68.2	16.8	63.3	15.7	59.1
1998	13.4	53.7	13.9	60.4	14.2	57.1	11.0	58.8	14.9	43.9	16.4	51.6
1999	14.4	64.5	13.7	64.9	15.3	70.0	10.9	64.7	14.0	69.1	12.2	58.2
2000	13.5	65.5	15.0	79.7	13.8	55.9	12.4	66.7	15.4	61.9	14.8	56.5
2001	13.8	57.1	16.2	57.1	8.3	38.9	14.7	60.9	13.6	66.7	14.2	60.3
2002	12.8	63.6	13.3	59.6	14.2	65.5	13.3	55.0	14.5	56.9	14.0	51.4
2003	15.0	56.9	13.1	54.8	12.2	50.0	8.6	66.7	15.4	57.9	13.3	55.9
2004	17.2	70.7	10.2	68.6	9.5	73.7	16.0	45.8	12.7	55.2	12.2	61.1
2005	12.2	78.1	8.5	53.6	12.1	73.9	10.7	68.8	16.0	62.0	12.9	56.2
2006	10.4	41.2	13.6	66.7	15.8	61.5	7.7	50.0	13.3	62.1	12.1	58.7
2007	13.5	57.1	11.4	50.0	12.4	73.7	7.2	63.6	11.8	63.2	11.9	53.3
2008	17.1	64.0	11.9	70.3	14.4	52.4	5.4	75.0	11.5	71.4	11.6	65.3
2009	8.9	76.9	14.9	67.4	11.7	68.4	9.6	75.0	12.7	58.3	9.8	61.2
2010	14.2	73.8	11.2	66.7	11.2	66.7	6.2	42.9	8.3	80.0	10.5	64.6
2011	10.6	76.5	10.3	77.4	7.4	92.3	1.7	100.0	13.0	59.4	9.3	63.4
2012	11.9	71.1	15.6	77.8	7.4	78.6	13.9	58.8	7.2	64.7	9.2	62.2
2013	10.7	58.8	10.0	77.4	11.5	72.7	9.8	81.8	9.6	70.6	9.3	62.3
2014	9.4	76.7	12.4	63.2	8.6	76.5	14.0	80.0	10.3	65.5	9.8	67.4
2015	11.7	65.9	14.8	80.4	9.2	52.6	7.3	88.9	11.0	66.7	9.2	69.2
2016	9.2	82.8	11.5	75.8	11.0	76.2	13.8	73.3	10.2	52.8	9.0	64.3
2017	12.8	78.1	11.1	66.7	10.2	78.9	11.8	92.3	8.6	53.5	9.0	68.1
2018	8.3	69.2	12.8	75.7	9.7	52.9	6.2	85.7	9.8	68.8	9.0	66.7
2019	8.8	81.5	11.4	67.7	11.6	88.9	8.5	77.8	9.9	70.8	8.7	64.6
2020	9.2	74.1	6.9	94.7	8.60	92.9	2.0	100.0	8.1	83.3	7.8	69.7
2021	8.1	77.3	13.4	83.3	10.9	62.5	7.8	85.7	7.0	73.3	9.2	67.7
Average	12.4	68.0	12.6	68.5	11.6	68.2	9.8	71.5	12.2	63.8	11.5	61.2

Year	Novo Hamburgo		São Leopoldo		Sapucaia do Sul		Esteio		Canoas		Porto Alegre
Year	PIM	PNM (%)	PIM	PNM (%)	PIM	PNM (%)	PIM	PNM (%)	PIM	PNM (%)	PIM	PNM (%)
1996	15.1	70.3	14.8	63.3	13.8	61.3	8.2	80.0	16.3	61.1	14.0	52.8
1997	7.5	72.6	8.5	67.7	10.2	80.0	10.9	68.6	13.4	67.9	12.4	61.4
1998	8.7	54.3	11.3	65.1	10.6	61.5	9.1	57.1	10.3	47.4	11.6	50.9
1999	9.0	69.2	8.7	75.0	11.4	73.3	7.0	72.7	10.0	71.7	9.1	62.4
2000	9.3	68.4	9.2	80.6	8.9	68.2	4.8	71.4	9.9	67.8	10.2	58.9
2001	7.9	67.9	11.0	63.2	6.0	38.5	10.2	75.0	9.2	68.6	10.1	62.6
2002	8.7	76.7	9.3	63.6	7.8	81.3	9.3	57.1	8.5	71.7	9.3	54.3
2003	10.0	61.8	7.2	69.6	9.2	44.4	7.8	72.7	11.0	64.8	8.4	59.9
2004	12.2	78.1	5.2	55.6	6.0	83.3	11.4	47.1	8.9	61.7	8.6	60.5
2005	7.2	91.7	6.1	65.0	6.8	76.9	8.0	75.0	10.7	64.8	8.8	60.8
2006	6.4	47.6	8.4	60.7	10.9	50.0	2.6	100.0	7.7	63.2	8.3	64.5
2007	9.0	60.7	9.8	44.8	8.5	69.2	3.3	60.0	8.5	70.7	7.8	56.1
2008	11.6	70.6	9.0	75.0	13.0	57.9	2.0	100.0	7.8	78.9	7.8	70.3
2009	4.1	91.7	11.0	61.8	8.0	84.6	7.2	77.8	8.2	69.2	7.0	67.2
2010	9.8	82.8	8.1	75.0	8.7	78.6	3.5	75.0	5.0	83.3	6.3	73.9
2011	6.8	90.9	7.6	82.6	5.1	100.0	1.7	100.0	9.8	66.7	5.8	69.7
2012	8.1	80.8	12.5	83.3	5.8	81.8	9.0	54.5	4.8	64.0	6.4	65.3
2013	6.0	73.7	5.2	81.3	8.4	75.0	8.0	88.9	6.2	87.9	6.3	68.0
2014	5.9	78.9	5.9	66.7	7.5	73.3	9.3	100.0	7.1	65.8	6.4	79.5
2015	6.9	66.7	9.7	83.3	5.8	66.7	6.5	87.5	7.3	70.0	5.8	79.1
2016	6.3	90.0	9.4	81.5	6.3	91.7	12.0	76.9	6.7	65.7	5.5	69.9
2017	9.3	83.3	7.7	69.6	6.6	75.0	9.0	100.0	4.4	63.6	6.2	74.6
2018	4.1	92.3	8.0	78.3	4.6	25.0	3.5	75.0	7.3	75.0	4.9	77.9
2019	5.5	76.5	8.5	78.3	10.3	93.8	5.7	83.3	6.0	75.9	5.9	70.1
2020	6.2	83.3	5.4	100.0	6.1	100.0	1.0	100.0	4.7	81.0	4.8	73.3
2021	4.0	72.7	10.0	85.2	6.1	77.8	4.5	100.0	4.9	76.2	6.0	78.8
Média	8.3	74.7	9.0	72.2	8.4	71.9	6.9	78.9	8.4	69.3	7.9	66.3

	Infant Mortality				Preventable Infant Mortality
	b	95% CI		p-valor	b	95% CI		p-valor
Novo Hamburgo	-0.291	-0.376	-0.207	<0.001	-0.253	-0.342	-0.163	<0.001
São Leopoldo	-0.133	-0237	-0.029	0.014	-0.116	-0.225	-0.006	0.040
Sapucaia do Sul	-0.209	-0.327	-0.091	0.001	-0.186	-0.305	-0.067	0.004
Esteio	-0.204	-0.393	-0.015	0.035	-0.153	-0.363	0.057	0.147
Canoas	-0.380	-0.468	-0.292	<0.001	-0.309	-0.384	-0.234	<0.001
Porto Alegre	-0.338	-0.400	-0.276	<0.001	-0.293	-0.363	-0.224	<0.001

	Per capita public spending on health*				Population coverage of FHS**
	b	95% CI		p-valor	b	95% CI		p-valor
Novo Hamburgo	48.357	28.940	67.775	<0.001	2.781	1.095	4.467	0.003
São Leopoldo	37.803	17.422	58.183	0.001	0.908	0.582	1.234	<0.001
Sapucaia do Sul	21.491	-8.438	51.419	0.149	2.690	1.979	3.401	<0.001
Esteio	70.634	35.446	105.823	<0.001	2.690	1.431	3.948	<0.001
Canoas	74.388	55.463	93.312	<0.001	2.695	1.350	4.040	<0.001
Porto Alegre	20.657	3.654	37.660	0.020	2.193	1.670	2.716	<0.001

	Per capita public spending on Health
	Infant Mortality				Preventable Infant Mortality
	b	95% CI		p-value	b	95% CI		p-value
Novo Hamburgo	-4.60	-7.45	-1.75	0.004	-3.04	-5.76	-0.32	0.031
São Leopoldo	1.02	-2.65	4.69	0.560	1.39	-3.52	6.31	0.553
Sapucaia do Sul	0.20	-7.76	8.16	0.957	-0.34	-8.66	1.88	0.189
Esteio	-0.60	-9.90	8.70	0.893	1.49	-7.12	10.10	0.717
Canoas	-4.59	-6.61	-2.58	<0.001	-3.13	-4.46	-1.79	<0.001
Porto Alegre	-7.61	-12.07	-3.14	0.003	-4.61	-8.12	-1.10	0.014
	Family Health Strategy
	Infant Mortality				Preventable Infant Mortality
	b	95% CI		p-value	b	95% CI		p-value
Novo Hamburgo	-0.063	-0.091	-0.035	<0.001	-0.047	-0.073	-0.020	0.001
São Leopoldo	-0.061	-0.210	0.088	0.406	-0.041	-0.179	0.097	0.541
Sapucaia do Sul	-0.059	-0.108	-0.010	0.021	-0.041	-0.088	0.006	0.086
Esteio	-0.049	-0.136	0.038	0.253	-0.029	-0.115	0.057	0.488
Canoas	-0.074	-0.118	-0.030	0.002	-0.060	-0.089	-0.031	<0.001
Porto Alegre	-0.129	-0.174	-0.084	<0.001	-0.109	-0.144	-0.073	<0.001

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[TFN6n] IM: Infant mortality rate per 1.000 inhabitants; NM: neonatal mortality rate.