Avaliação do processo de investigação e análise de óbitos maternos, fetais e infantis em uma região de saúde de Minas Gerais, Brasil

Abstract

Reducing stillbirths and mortality in mothers and infants is a national and international priority due to the high potential preventability of these deaths. Mortality surveillance and the implantation of Committees for the Prevention of Mortality are an important mechanism to reach this target. In the State of Minas Gerais, Brazil, the Regional Health Superintendence of Belo Horizonte incorporates 39 municipalities in which indicatorsof maternal, infant, and perinatal mortality can stand to be further improved; surveillance and these Committees are in various stages of structuring and organization. Objective: To evaluate the structure, process, and outcomes of mortality surveillance and the Committeesfor the Prevention of Stillbirths, Infant and Maternal Mortality in the municipalities of the Regional Health Superintendence of Belo Horizonte. Methods: This is an ecological descriptive study. A validated questionnaire was applied to the municipal technical referencesto assess surveillance of stillbirths, maternal, and infant mortality and the municipal committees. Municipalities were evaluated and classified according to their appropriation to the standard of the Health Ministry in the component areas of Structure, Process, and Outcome domains. The descriptive analysis of these appropriation variables, in the areas anddomains, was performed by population size and management type categories of the municipalities. Results: From the 38 municipalities analyzed, only 5.3% had their Committees structures classified as appropriate and 8.4% were appropriate concerning its process. In Result domain, 27.8% of the municipalities were appropriate. In the detailedanalysis of the areas, it was observed, in general, large municipalities and those with full management of the municipal system presented the best percentages of appropriation. Conclusions: This assessment identified mortality surveillance and the Committees for the Prevention of Stillbirths, Infant and Maternal Mortality in the municipalities of the Regional Health Superintendence are, in general, inappropriate. Municipalities heterogeneities in population size and management type have to be recognized so surveillance and committees can better operate. Studies are necessary to analyze the impact of mortality surveillance strategy recommended in Brazil on mortality reduction.