Impact evaluation of two strategies combined to reduce the infant mortality in Tucumán, Argentina

Abstract

In 2003, the infant mortality rate in Tucuman was one of the highest in the country. In 2004, two strategies were implemented in order to reduce it: Strengthening the first level of care and optimization of tertiary neonatal care. OBJECTIVE: To evaluate the impact on the infant mortality of both strategies after 4 years of implementation. METHOD: The changes of three indicators were compared between 2003 and 2007 and by 4-years periods 2000-03 and 2004-07: 1) Proportion of newborns by birthweigh interval of total live births in the period in order to assess the strengthening of prenatal controls; 2) Changes in post-neonatal mortality rate, to estimate the effect of strengthening the healthy child controls; 3) Proportion of child deaths by birthweight interval of total live births in that interval in the period to measure the effect of improving the high complexity neonatal care services. The statistical analysis was performed with x2 and segmented regression. RESULTS: The proportion of infants with less than 1,500 g fell from 1.33% in 2003 to 1.26% in 2007 (p = 0.44). The posneonatal mortality rate fell from 6.4 ‰ in 2003 to 3.8 ‰ in 2007. The proportion of dead children in the range of less than 1,500 g was reduced from 91.30% in 2003 to 46.40% in 2007 (p = 0.00). The infant mortality rate was 22.9 ‰ in 2003 and 12.9 ‰ in 2007. CONCLUSION: Both strategies had a positive result in accordance to their objectives, although the improvement of tertiary care services showed a more signifficant impact.