Social determinants of infant mortality in border municipalities from Colombia. 2005-2011

Abstract

Introduction: In Colombia, infant mortality rates in border municipalities greatly differ from the national average, making the identification of infant mortality determinants in these areas a priority to guide the development of public health policies. Objective: To identify some social determinants of infant mortality in Colombian border municipalities from 2005 to 2011. Materials and methods: An ecological study was conducted. Three regression models were built for the following categories: 1) structural determinants; 2) intermediate determinants of living and working conditions, behavioral and biological factors, and psychosocial factors, and 3) intermediate determinants of the Colombian health system. Results: According to the data found in the present study it is possible to suggest that infant mortality in border municipalities is associated with ethnicity, race, education, infant dependency ratio, low birth weight, water quality, rurality, being in a female headed household, vaccination coverage, prenatal care coverage, level of satisfaction with the provision of health services, and healthcare system membership. Conclusions: Most of determinants of infant mortality in these municipalities exceed the scope of the health sector; therefore, the Colombian State faces two important challenges: to implement a trans-sectoral and cross-border approach, and to provide, with a health equity approach, an institutional response that adapts to the needs and culture of each municipality and region.