Association of Previne Brasil Program with prenatal care and maternal-child mortality

Abstract

OBJECTIVE: To investigate the impact of prenatal care on the reduction of maternal-child mortality in Brazilian municipalities following the new primary health care financing model, the Previne Brasil program. METHODS: This study comprised a nationwide cross-sectional observational analysis, utilizing secondary data from Departamento de Informática do Sistema Único de Saúde (Datasus – Information Technology Department of the Unified Health System), Sistema de Informação sobre Mortalidade (SIM – Mortality Information System), Sistema de Informação sobre Nascidos Vivos (Sinasc – Live Birth Information System), Sistema de Informação em Saúde para a Atenção Básica (Sisab – Primary Health Care Information System), and Instituto Brasileiro de Geografia e Estatística (IBGE – Brazilian Institute of Geography and Statistics). Medians of maternal mortality, infant mortality, and prenatal care rates were calculated for Brazilian municipalities from 2016 to 2022. Logistic regression analyses were conducted to assess associations between independent variables (primary care coverage, population size, Gross Domestic Product, and Gini index) and outcomes (variations in maternal and infant mortality rates). Both crude and adjusted odds ratios were estimated, with a significance level of 5%. RESULTS: Prenatal care rates increased by 86.7%, while maternal mortality rates decreased by 30.9%, with no association between them. Region, primary care coverage, municipal Gross Domestic Product, and population size were associated with variations in maternal mortality rates. The Southern region had a higher likelihood of reducing maternal mortality. No association was found between increased prenatal care rates and reduced infant mortality. Regional location, primary care coverage, population size, and the Gini index were associated with variations in infant mortality rates, with greater reductions observed in more populous municipalities and in the Northeast, Southeast, and Midwest. CONCLUSION: The Previne Brasil program led to an increase in prenatal care consultations in Brazilian municipalities but did not significantly impact the reduction of maternal-child mortality.