Impacto da Estratégia de Saúde da Família sobre as taxas de mortalidade infantil nos municípios no período de 2008 a 2019

Abstract

We problematize in this work, understanding the impact of the public policy Family Health Strategy (ESF) on infant mortality rates up to one year of age. We focus on the evaluation aspect, analyzing the problem of infant mortality, the success and failures of the programmed elements. To this end, we carried out descriptive research and an explanatory study that aimed to identify the elements that favored the realization of the phenomenon of the dependent variable: Infant Mortality Rate. As a result, we note that among the 5570 municipalities, 1656 locations did not present public policy in a single year, representing 29.7% of Brazilian cities in this classification. Also throughout the period from 2008 to 2019, the number of cities that presented teams was 1380 locations, reflecting 24.78% of cities in Brazil. Teams were implemented in 279 municipalities from 2008 to 2019, representing an increase of 11%. Jumping in 2008 from 2462 to 2741 in 2019, having the largest number of cities in 2016 with 2903 municipalities. We observed a growth from 10,577 teams in 2008 to 15,893 in 2019, in this case, an increase of 5,316 ESF teams, that is, a 50% increase. We also saw an increase in municipalities over the 12-year period that observed the PNAB (One ESF for every 3,000), with 94 municipalities in 2008 to 150 in 2019. A jump of 81 cities. Finally, we identified that public policy represented a decrease in child deaths, even in cities that did not comply with the PNAB criteria (One team for 3,000). In the inferential analysis, it was observed that for each increase in the Family Health Strategy Rate in 2019, there was a decrease of 0.23 in the log of the Infant Mortality Rate. Also, for each increase in the 2019 Fiscal Management Index, there was a decrease of 0.31 in the Infant Mortality Rate. Focusing on the difference-in-differences technique, the model for all of Brazil (model1), from 2014 onwards, for the municipalities that implemented the public policy, there was an average decrease of 1.5 in their Infant Mortality Rate, which could be proven by the Difference variable, followed by its coefficient.