Spatial analysis of avoidable infant deaths in Espírito Santo, Brazil, 2006-2013

Abstract

Objective: to analyze spatial distribution of avoidable infant deaths in Espírito Santo state, Brazil, 2006-2013. Methods: this was an ecological study of infant deaths recorded on the Mortality Information System and classified according to the method used by the International Collaborative Effort on Perinatal and Infant Mortality (ICE). Avoidable death rates were calculated and smoothed by global and local Bayesian estimators. Local Moran’s Index was used to verify local spatial correlation. Results: of the 5,089 deaths, 4,805 were classified as per ICE, 77.2% of which were avoidable. The crude mean rate was 9.68/1.000 live births, reducing to 8.96/1.000 live births after applying the global Bayesian estimator. The municipality of Jerônimo Monteiro had the highest rate (20.1/1.000 live births). The Local Moran’s Index showed weak spatial correlation of 0.197 (p-value=0.02). Conclusion: there were clusters of municipalities in the Central and Southern regions of the state, suggesting the need for adequate monitoring in these areas where there is a higher risk of avoidable deaths.