Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://hdl.handle.net/1843/59457 |
Resumo: | Objective: The objective of this study was to better understand how the lack of emergency child and obstetric care can be related to maternal and neonatal mortality levels. Methods: We performed spatiotemporal geospatial analyses using data from Brazilian municipalities. An emergency service accessibility index was derived using the two-step floating catchment area (2SFCA) for 951 hospitals. Mortality data from 2000 to 2015 was used to characterize space-time trends. The data was overlapped using a spatial clusters analysis to identify regions with lack of emergency access and high mortality trends. Results: From 2000 to 2015 Brazil the overall neonatal mortality rate varied from 11,42 to 11,71 by 1000 live births. The maternal mortality presented a slightly decrease from 2,98 to 2,88 by 100 thousand inhabitants. For neonatal mortality the Northeast and North regions presented the highest percentage of up trending. For maternal mortality the North region exhibited the higher volume of up trending. The accessibility index obtained highlighted large portions of the rural areas of the country without any coverage of obstetric or neonatal beds.Conclusions: The analyses highlighted regions with problems of mortality and access to maternal and newborn emergency services. This sequence of steps can be applied to other low and medium income countries as health situation analysis tool. Significance statement Low and middle income countries have greater disparities in access to emergency child and obstetric care. There is a lack of approaches capable to support analysis considering a spatiotemporal perspective for emergency care. Studies using Geographic Information System analysis for maternal and child care, are increasing in frequency. This approach can identify emergency child and obstetric care saturated or deprived regions. The sequence of steps designed here can help researchers, and policy makers to better design strategies aiming to improve emergency child and obstetric care. |
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2023-10-16T18:12:45Z2023-10-16T18:12:45Z2020151e02359542010.1371/journal.pone.02359541932-6203http://hdl.handle.net/1843/59457Objective: The objective of this study was to better understand how the lack of emergency child and obstetric care can be related to maternal and neonatal mortality levels. Methods: We performed spatiotemporal geospatial analyses using data from Brazilian municipalities. An emergency service accessibility index was derived using the two-step floating catchment area (2SFCA) for 951 hospitals. Mortality data from 2000 to 2015 was used to characterize space-time trends. The data was overlapped using a spatial clusters analysis to identify regions with lack of emergency access and high mortality trends. Results: From 2000 to 2015 Brazil the overall neonatal mortality rate varied from 11,42 to 11,71 by 1000 live births. The maternal mortality presented a slightly decrease from 2,98 to 2,88 by 100 thousand inhabitants. For neonatal mortality the Northeast and North regions presented the highest percentage of up trending. For maternal mortality the North region exhibited the higher volume of up trending. The accessibility index obtained highlighted large portions of the rural areas of the country without any coverage of obstetric or neonatal beds.Conclusions: The analyses highlighted regions with problems of mortality and access to maternal and newborn emergency services. This sequence of steps can be applied to other low and medium income countries as health situation analysis tool. Significance statement Low and middle income countries have greater disparities in access to emergency child and obstetric care. There is a lack of approaches capable to support analysis considering a spatiotemporal perspective for emergency care. Studies using Geographic Information System analysis for maternal and child care, are increasing in frequency. This approach can identify emergency child and obstetric care saturated or deprived regions. The sequence of steps designed here can help researchers, and policy makers to better design strategies aiming to improve emergency child and obstetric care.Objetivo: O objetivo deste estudo foi compreender melhor como a falta de atendimento emergencial infantil e obstétrico pode estar relacionada aos níveis de mortalidade materna e neonatal. Métodos: Realizamos análises geoespaciais espaço-temporais utilizando dados de municípios brasileiros. Um índice de acessibilidade aos serviços de emergência foi derivado usando a área de captação flutuante de duas etapas (2SFCA) para 951 hospitais. Dados de mortalidade de 2000 a 2015 foram utilizados para caracterizar tendências espaço-temporais. Os dados foram sobrepostos utilizando uma análise de agrupamentos espaciais para identificar regiões com falta de acesso de emergência e tendências de mortalidade elevada. Resultados: De 2000 a 2015 no Brasil a taxa geral de mortalidade neonatal variou de 11,42 a 11,71 por 1000 nascidos vivos. A mortalidade materna apresentou uma ligeira diminuição de 2,98 para 2,88 por 100 mil habitantes. Para a mortalidade neonatal as regiões Nordeste e Norte apresentaram os maiores percentuais de tendência de alta. Para a mortalidade materna a região Norte apresentou o maior volume de tendência de alta. O índice de acessibilidade obtido destacou grandes porções das áreas rurais do país sem qualquer cobertura de leitos obstétricos ou neonatais.Conclusões: As análises destacaram regiões com problemas de mortalidade e acesso a serviços de emergência materna e neonatal. Esta sequência de passos pode ser aplicada a outros países de baixo e médio rendimento como ferramenta de análise da situação de saúde. Declaração de significância Os países de rendimento baixo e médio apresentam maiores disparidades no acesso a cuidados infantis e obstétricos de emergência. Faltam abordagens capazes de subsidiar análises considerando uma perspectiva espaçotemporal para o atendimento emergencial. Estudos que utilizam análises de Sistemas de Informação Geográfica para cuidados materno-infantis estão aumentando em frequência. Esta abordagem pode identificar regiões saturadas ou carentes de cuidados obstétricos e infantis de emergência. A sequência de passos aqui concebidos pode ajudar os investigadores e os decisores políticos a melhor conceber estratégias com o objetivo de melhorar os cuidados obstétricos e infantis de emergênciaengUniversidade Federal de Minas GeraisUFMGBrasilFCE - DEPARTAMENTO DE CIÊNCIAS ECONÔMICASPLOS ONEMortalidade infantilEmergênciasLack of emergency childObstetric careMaternal and neonatal mortality levelsComprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approachinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://https://journals.plos.org/plosone/article/metrics?id=10.1371/journal.pone.0235954Nubia Cristinada SilvaLuiz Augusto FacchiniThiago Augusto Hernandes RochaPedro Amaral VasconcelosCyrus ElahiElaine ThumeErika Barbara ThomazRejane QueirozJoão Ricardo Nickenig VissociCatherine Statoninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALCompreending the lack of access to maternal and neonatal emergency care.pdfCompreending the lack of access to maternal and neonatal emergency care.pdfapplication/pdf1858514https://repositorio.ufmg.br/bitstream/1843/59457/2/Compreending%20the%20lack%20of%20access%20to%20maternal%20and%20neonatal%20emergency%20care.pdf3c2f04e00f2f6942646da429eab76522MD52LICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/59457/1/License.txtfa505098d172de0bc8864fc1287ffe22MD511843/594572023-10-16 16:41:13.439oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-10-16T19:41:13Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach |
title |
Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach |
spellingShingle |
Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach Nubia Cristinada Silva Lack of emergency child Obstetric care Maternal and neonatal mortality levels Mortalidade infantil Emergências |
title_short |
Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach |
title_full |
Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach |
title_fullStr |
Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach |
title_full_unstemmed |
Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach |
title_sort |
Comprehending the lack of access to maternal and neonatal emergency care: designing solutions based on a space-time approach |
author |
Nubia Cristinada Silva |
author_facet |
Nubia Cristinada Silva Luiz Augusto Facchini Thiago Augusto Hernandes Rocha Pedro Amaral Vasconcelos Cyrus Elahi Elaine Thume Erika Barbara Thomaz Rejane Queiroz João Ricardo Nickenig Vissoci Catherine Staton |
author_role |
author |
author2 |
Luiz Augusto Facchini Thiago Augusto Hernandes Rocha Pedro Amaral Vasconcelos Cyrus Elahi Elaine Thume Erika Barbara Thomaz Rejane Queiroz João Ricardo Nickenig Vissoci Catherine Staton |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Nubia Cristinada Silva Luiz Augusto Facchini Thiago Augusto Hernandes Rocha Pedro Amaral Vasconcelos Cyrus Elahi Elaine Thume Erika Barbara Thomaz Rejane Queiroz João Ricardo Nickenig Vissoci Catherine Staton |
dc.subject.por.fl_str_mv |
Lack of emergency child Obstetric care Maternal and neonatal mortality levels |
topic |
Lack of emergency child Obstetric care Maternal and neonatal mortality levels Mortalidade infantil Emergências |
dc.subject.other.pt_BR.fl_str_mv |
Mortalidade infantil Emergências |
description |
Objective: The objective of this study was to better understand how the lack of emergency child and obstetric care can be related to maternal and neonatal mortality levels. Methods: We performed spatiotemporal geospatial analyses using data from Brazilian municipalities. An emergency service accessibility index was derived using the two-step floating catchment area (2SFCA) for 951 hospitals. Mortality data from 2000 to 2015 was used to characterize space-time trends. The data was overlapped using a spatial clusters analysis to identify regions with lack of emergency access and high mortality trends. Results: From 2000 to 2015 Brazil the overall neonatal mortality rate varied from 11,42 to 11,71 by 1000 live births. The maternal mortality presented a slightly decrease from 2,98 to 2,88 by 100 thousand inhabitants. For neonatal mortality the Northeast and North regions presented the highest percentage of up trending. For maternal mortality the North region exhibited the higher volume of up trending. The accessibility index obtained highlighted large portions of the rural areas of the country without any coverage of obstetric or neonatal beds.Conclusions: The analyses highlighted regions with problems of mortality and access to maternal and newborn emergency services. This sequence of steps can be applied to other low and medium income countries as health situation analysis tool. Significance statement Low and middle income countries have greater disparities in access to emergency child and obstetric care. There is a lack of approaches capable to support analysis considering a spatiotemporal perspective for emergency care. Studies using Geographic Information System analysis for maternal and child care, are increasing in frequency. This approach can identify emergency child and obstetric care saturated or deprived regions. The sequence of steps designed here can help researchers, and policy makers to better design strategies aiming to improve emergency child and obstetric care. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2023-10-16T18:12:45Z |
dc.date.available.fl_str_mv |
2023-10-16T18:12:45Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/59457 |
dc.identifier.doi.pt_BR.fl_str_mv |
10.1371/journal.pone.0235954 |
dc.identifier.issn.pt_BR.fl_str_mv |
1932-6203 |
identifier_str_mv |
10.1371/journal.pone.0235954 1932-6203 |
url |
http://hdl.handle.net/1843/59457 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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PLOS ONE |
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openAccess |
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Universidade Federal de Minas Gerais |
dc.publisher.initials.fl_str_mv |
UFMG |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
FCE - DEPARTAMENTO DE CIÊNCIAS ECONÔMICAS |
publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais |
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reponame:Repositório Institucional da UFMG instname:Universidade Federal de Minas Gerais (UFMG) instacron:UFMG |
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