Association of the Previne Brasil Program in prenatal care and maternal-child mortality

Abstract

Abstract Background: Brazil has witnessed a significant reduction in maternal-child mortality with the establishment of the Unified Health System. However, the rates remain high and should be mitigated through effective public policies that comprehend the factors involved in these elevated rates. Objective: To investigate the impact of prenatal care on the reduction of maternal-child mortality in Brazilian municipalities following the new financing model of Primary Health Care, the Previne Brasil program. Methods: This study comprised a nationwide cross-sectional observational analysis, utilizing secondary data from the Brazilian public health system. Medians of maternal mortality, infant mortality, and prenatal care rates were calculated for Brazilian municipalities from 2016 to 2022. Logistic regression analyses were conducted to assess associations between independent variables (primary care coverage, population, Gross Domestic Product, and Gini index) and outcomes (variation in maternal and infant death rates). Raw and adjusted odds ratios were estimated, with a significance level set at 5%. Results: Prenatal care rates increased by 86.7%, while maternal death rates decreased by 30.9%, with no significant association between them (p>0.05). Region, primary care coverage, municipal GDP, and population showed significant associations (p<0.05) with the variation in maternal death rates. The Southern region had a higher chance of reducing maternal death rates. No significant association was found between an increase in prenatal care rates and a decrease in infant death rates (p>0.05). The country's region, primary care coverage, population, and Gini index were significantly associated (p<0.05) with the variation in infant death rates, with a greater chance of reduction in more populous municipalities and in the Northeast, Southeast, and Midwest regions. Conclusion: The Previne Brasil Program led to an increase in prenatal care consultations in Brazilian municipalities but did not significantly impact the reduction of maternal-child mortality.