Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012

Detalhes bibliográficos
Autor(a) principal: Martins-Melo, Francisco Rogerlândio
Data de Publicação: 2014
Outros Autores: Lima, Mauricélia da Silveira, Alencar, Carlos Henrique, Ramos Jr, Alberto Novaes, Carvalho, Francisco Herlânio Costa, Machado, Márcia Maria Tavares, Heukelbach, Jorg
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/84400
Resumo: OBJECTIVE To analyze temporal trends and distribution patterns of unsafe abortion in Brazil. METHODS Ecological study based on records of hospital admissions of women due to abortion in Brazil between 1996 and 2012, obtained from the Hospital Information System of the Ministry of Health. We estimated the number of unsafe abortions stratified by place of residence, using indirect estimate techniques. The following indicators were calculated: ratio of unsafe abortions/100 live births and rate of unsafe abortion/1,000 women of childbearing age. We analyzed temporal trends through polynomial regression and spatial distribution using municipalities as the unit of analysis. RESULTS In the study period, a total of 4,007,327 hospital admissions due to abortions were recorded in Brazil. We estimated a total of 16,905,911 unsafe abortions in the country, with an annual mean of 994,465 abortions (mean unsafe abortion rate: 17.0 abortions/1,000 women of childbearing age; ratio of unsafe abortions: 33.2/100 live births). Unsafe abortion presented a declining trend at national level (R2: 94.0%, p < 0.001), with unequal patterns between regions. There was a significant reduction of unsafe abortion in the Northeast (R2: 93.0%, p < 0.001), Southeast (R2: 92.0%, p < 0.001) and Central-West regions (R2: 64.0%, p < 0.001), whereas the North (R2: 39.0%, p = 0.030) presented an increase, and the South (R2: 22.0%, p = 0.340) remained stable. Spatial analysis identified the presence of clusters of municipalities with high values for unsafe abortion, located mainly in states of the North, Northeast and Southeast Regions. CONCLUSIONS Unsafe abortion remains a public health problem in Brazil, with marked regional differences, mainly concentrated in the socioeconomically disadvantaged regions of the country. Qualification of attention to women’s health, especially to reproductive aspects and attention to pre- and post-abortion processes, are necessary and urgent strategies to be implemented in the country.
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spelling Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012 Tendência temporal e distribuição espacial do aborto inseguro no Brasil, 1996-2012 OBJECTIVE To analyze temporal trends and distribution patterns of unsafe abortion in Brazil. METHODS Ecological study based on records of hospital admissions of women due to abortion in Brazil between 1996 and 2012, obtained from the Hospital Information System of the Ministry of Health. We estimated the number of unsafe abortions stratified by place of residence, using indirect estimate techniques. The following indicators were calculated: ratio of unsafe abortions/100 live births and rate of unsafe abortion/1,000 women of childbearing age. We analyzed temporal trends through polynomial regression and spatial distribution using municipalities as the unit of analysis. RESULTS In the study period, a total of 4,007,327 hospital admissions due to abortions were recorded in Brazil. We estimated a total of 16,905,911 unsafe abortions in the country, with an annual mean of 994,465 abortions (mean unsafe abortion rate: 17.0 abortions/1,000 women of childbearing age; ratio of unsafe abortions: 33.2/100 live births). Unsafe abortion presented a declining trend at national level (R2: 94.0%, p < 0.001), with unequal patterns between regions. There was a significant reduction of unsafe abortion in the Northeast (R2: 93.0%, p < 0.001), Southeast (R2: 92.0%, p < 0.001) and Central-West regions (R2: 64.0%, p < 0.001), whereas the North (R2: 39.0%, p = 0.030) presented an increase, and the South (R2: 22.0%, p = 0.340) remained stable. Spatial analysis identified the presence of clusters of municipalities with high values for unsafe abortion, located mainly in states of the North, Northeast and Southeast Regions. CONCLUSIONS Unsafe abortion remains a public health problem in Brazil, with marked regional differences, mainly concentrated in the socioeconomically disadvantaged regions of the country. Qualification of attention to women’s health, especially to reproductive aspects and attention to pre- and post-abortion processes, are necessary and urgent strategies to be implemented in the country. OBJETIVO Analisar tendências temporais e padrões de distribuição espacial do aborto inseguro no Brasil. MÉTODOS Estudo ecológico realizado com base nos registros das internações hospitalares de mulheres por abortamento no Brasil, no período de 1996-2012, obtidos do Sistema de Informações Hospitalares do Ministério da Saúde. Estimou-se o número de abortos inseguros segundo local de residência, utilizando-se técnicas de estimativas indiretas. Foram calculados os indicadores: razão de aborto inseguro por 100 nascidos vivos e coeficiente de aborto inseguro por 1.000 mulheres em idade fértil. As tendências temporais foram analisadas por regressão polinomial e a distribuição espacial utilizando os municípios brasileiros como unidade de análise. RESULTADOS Foram registradas 4.007.327 internações hospitalares por abortamento no Brasil no período. Estimou-se um total de 16.905.911 abortos inseguros, com média anual de 994.465 abortos (coeficiente médio de aborto inseguro de 17,0 abortos/1.000 mulheres em idade fértil e razão de 33,2 abortos inseguros/100 nascidos vivos). O aborto inseguro apresentou tendência de declínio em nível nacional (R2: 94,0%; p < 0,001), com padrões desiguais entre as regiões. As regiões Nordeste (R2: 93,0%; p < 0,001), Sudeste (R2: 92,0%; p < 0,001) e Centro-Oeste (R2: 64,0%; p < 0,001) apresentaram tendência de declínio, enquanto a região Norte (R2: 39,0%; p = 0,030), tendência de aumento, e a região Sul (R2: 22,0%; p = 0,340), de estabilidade. A análise espacial identificou a presença de clusters de municípios com altos valores de abortos inseguros, localizados especialmente em estados das regiões Norte, Nordeste e Sudeste. CONCLUSÕES O aborto inseguro se mantém como problema de saúde pública no Brasil, com marcantes diferenças regionais e concentradas nas regiões socioeconomicamente menos favorecidas do País. A qualificação da atenção à saúde da mulher, em especial aos aspectos reprodutivos e de atenção aos processos pré e pós-abortamento, são estratégias necessárias e urgentes. Universidade de São Paulo. Faculdade de Saúde Pública2014-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/8440010.1590/S0034-8910.2014048004878Revista de Saúde Pública; Vol. 48 No. 3 (2014); 508-520Revista de Saúde Pública; Vol. 48 Núm. 3 (2014); 508-520Revista de Saúde Pública; v. 48 n. 3 (2014); 508-5201518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPengporhttps://www.revistas.usp.br/rsp/article/view/84400/87190https://www.revistas.usp.br/rsp/article/view/84400/87191Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessMartins-Melo, Francisco Rogerlândio Lima, Mauricélia da Silveira Alencar, Carlos Henrique Ramos Jr, Alberto Novaes Carvalho, Francisco Herlânio Costa Machado, Márcia Maria Tavares Heukelbach, Jorg 2014-09-03T18:50:46Zoai:revistas.usp.br:article/84400Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2014-09-03T18:50:46Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012
Tendência temporal e distribuição espacial do aborto inseguro no Brasil, 1996-2012
title Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012
spellingShingle Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012
Martins-Melo, Francisco Rogerlândio
title_short Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012
title_full Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012
title_fullStr Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012
title_full_unstemmed Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012
title_sort Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012
author Martins-Melo, Francisco Rogerlândio
author_facet Martins-Melo, Francisco Rogerlândio
Lima, Mauricélia da Silveira
Alencar, Carlos Henrique
Ramos Jr, Alberto Novaes
Carvalho, Francisco Herlânio Costa
Machado, Márcia Maria Tavares
Heukelbach, Jorg
author_role author
author2 Lima, Mauricélia da Silveira
Alencar, Carlos Henrique
Ramos Jr, Alberto Novaes
Carvalho, Francisco Herlânio Costa
Machado, Márcia Maria Tavares
Heukelbach, Jorg
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Martins-Melo, Francisco Rogerlândio
Lima, Mauricélia da Silveira
Alencar, Carlos Henrique
Ramos Jr, Alberto Novaes
Carvalho, Francisco Herlânio Costa
Machado, Márcia Maria Tavares
Heukelbach, Jorg
description OBJECTIVE To analyze temporal trends and distribution patterns of unsafe abortion in Brazil. METHODS Ecological study based on records of hospital admissions of women due to abortion in Brazil between 1996 and 2012, obtained from the Hospital Information System of the Ministry of Health. We estimated the number of unsafe abortions stratified by place of residence, using indirect estimate techniques. The following indicators were calculated: ratio of unsafe abortions/100 live births and rate of unsafe abortion/1,000 women of childbearing age. We analyzed temporal trends through polynomial regression and spatial distribution using municipalities as the unit of analysis. RESULTS In the study period, a total of 4,007,327 hospital admissions due to abortions were recorded in Brazil. We estimated a total of 16,905,911 unsafe abortions in the country, with an annual mean of 994,465 abortions (mean unsafe abortion rate: 17.0 abortions/1,000 women of childbearing age; ratio of unsafe abortions: 33.2/100 live births). Unsafe abortion presented a declining trend at national level (R2: 94.0%, p < 0.001), with unequal patterns between regions. There was a significant reduction of unsafe abortion in the Northeast (R2: 93.0%, p < 0.001), Southeast (R2: 92.0%, p < 0.001) and Central-West regions (R2: 64.0%, p < 0.001), whereas the North (R2: 39.0%, p = 0.030) presented an increase, and the South (R2: 22.0%, p = 0.340) remained stable. Spatial analysis identified the presence of clusters of municipalities with high values for unsafe abortion, located mainly in states of the North, Northeast and Southeast Regions. CONCLUSIONS Unsafe abortion remains a public health problem in Brazil, with marked regional differences, mainly concentrated in the socioeconomically disadvantaged regions of the country. Qualification of attention to women’s health, especially to reproductive aspects and attention to pre- and post-abortion processes, are necessary and urgent strategies to be implemented in the country.
publishDate 2014
dc.date.none.fl_str_mv 2014-06-01
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info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/84400
10.1590/S0034-8910.2014048004878
url https://www.revistas.usp.br/rsp/article/view/84400
identifier_str_mv 10.1590/S0034-8910.2014048004878
dc.language.iso.fl_str_mv eng
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language eng
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dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/84400/87190
https://www.revistas.usp.br/rsp/article/view/84400/87191
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 48 No. 3 (2014); 508-520
Revista de Saúde Pública; Vol. 48 Núm. 3 (2014); 508-520
Revista de Saúde Pública; v. 48 n. 3 (2014); 508-520
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
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reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
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