Infant mortality in the Federal District, Brazil: time trend and socioeconomic inequalities

This study examined the trend in the infant mortality rate in the Federal District of Brazil (or Greater Metropolitan Brasilia, the national capital) from 1990 to 2000, analyzing the rate according to 5 administrative areas stratified by mean family income, from 1996 to 2000. An ecological time-series study was conducted using the Information Systems on Live Births and Mortality, produced by the Brazilian Ministry of Health. The infant mortality rate (IMR) decreased by 45.2% from 1990 to 2000, from 26.3 per 1000 live births to 14.4, or a mean annual reduction of 5.34% (R-2 = 0.9397; p < 0.0001). During this period there was a higher proportion of neonatal deaths. However, a higher percentage change occurred in the post-neonatal period (-59.0%, R-2 = 0.8452, p < 0.0001). Investigation of the IMR in the various areas of the Federal District showed a reduction in differences among the regions with respect to the component rates; however, substantial disparities persisted in relation to the income variable. The results suggest the need for effective interventions in the determinants of neonatal and post-neonatal mortality in order to improve maternal and infant health in all socioeconomic groups in the Federal District.