Infant mortality and child health in Brazil

Child health is a central issue in the public policy agenda of developing countries. Several policies aimed at improving child health have been implemented over the years, with varying degrees of success. In Brazil, such policies have triggered a significant decline in infant mortality rates over the last 30 years. Despite this improvement, however, mortality rates are still high compared to international standards. Moreover, there is considerable imbalance across Brazilian municipalities suggesting that various policies should be adopted. We investigate the determinants of infant mortality at the municipal level and provide an analysis of the factors affecting child health at the individual level. To analyze the mortality rate, we estimate static and dynamic panel data models using four censuses covering the period from 1970 to 2000. The demand for child health, on the other hand, is addressed through a household decision model, estimated using anthropometric data from the 1996 Standard of Living Survey. The results obtained indicate that a rise in sanitation, education and per capita income contributed to the decline of infant mortality in Brazil, with stronger impacts in the long run than in the short run. The fixed effects associated with county characteristics explain the observed dispersion in child mortality rates. The results from the decision model are confirmed by the findings of the mortality model: education, sanitation and poverty are the most important causes of poor child health in Brazil. (C) 2004 Elsevier B.V. All rights reserved.