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Progress of neonatal mortality in a metropolitan area of Southeastern Brazil from 1979 to 1993. 1 - Analysis by age-group according to area of residence

The behavior of the infant mortality rate in the State of Rio de Janeiro, Brazil, from 1979 to 1993, is analysed. The annual rate of variation, calculated as the slope of an exponential regression model, indicates an overall decreasing trend of approximately 5% per year. Although the neonatal component is also decreasing, the annual rate of variation is much lower, of only 2,4% per year, and is even lower (1,6%) when deaths caused by malnutrition or infectious diseases are not taken into account. Examining date by region of residence, the area composed of the counties located outside the metropolitan region - called the "Interior" - presents the worst perfomance. When mortality rates are analysed by age-group an interesting pattern is found: the shorter the time of life the lower the value of the rate variation. In contrast to what is found in developed countries, where care is more intensive for newborn children, the infant mortality rate in Rio de Janeiro State dedreases less as the number of hours of life approaches the delivery: for the groups of deathas that occurred within the first of life, an increasing trend is found in all of the residencial regions considered in this study. To face this situation, it is necessary to re-affirm the priorities of the health services, not only in respect to the improvement of the quality of medical assistance but also to the development of strategies for the epidemiological monitoring of the Brazilian situation

Infant mortality; Neonatal mortality; Quality of health care

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