Affiliation:
1. Post‐Graduate Program on Child and Adolescent Health Universidade Federal de Pernambuco (UFPE) Recife Pernambuco Brazil
2. Department of Physical Therapy Universidade Federal da Paraíba (UFPB) João Pessoa Paraíba Brazil
3. Department of Physical Therapy Universidade Federal de Pernambuco (UFPE) Recife Pernambuco Brazil
Abstract
AimTo evaluate the methodological quality of studies that analysed the relationship between accessibility to emergency services and infant mortality.MethodsA systematic review with meta‐analysis, registered on the international prospective register of systematic reviews (PROSPERO) platform under code CRD42021279854. Medline/Pubmed, Embase, SciElo, Lilacs, Scopus and web of science electronic databases were searched between November 2021 and May 2024, without language or publication time restriction. We included observational studies that compared the infant mortality outcome with the different distances travelled or travel time to health services in a paediatric emergency. Thus, we excluded studies with primary outcomes present in the pre‐ and perinatal periods, as well as distances or travel time to obstetric emergency units. We used the grade to assess the methodological quality of the studies and the Newcastle‐Ottawa scale for the risk of bias, in addition to performing a meta‐analysis.ResultsThe evidence quality on infant mortality was moderate for four studies and low for three studies. The meta‐analysis showed that children who travelled more than 5 km to the emergency service had a 28% increase in the chance of dying (P = 0.002), as well as those travelling for more than 40 min increased by 45% (P < 0.001).ConclusionsThere was a relationship between the increase in geographic accessibility distance and travel time with the increase in infant mortality. However, the studies still showed moderate to low methodological quality.