[EQ] Tackling Health Inequities in Chile

Tackling Health Inequities in Chile:
Maternal, Newborn, Infant, and Child Mortality Between 1990 and 2004

Rogelio Gonzalez is with Pontificia Catholic University of Chile, Santiago, and the Division of Prevention and Control of Diseases, Chilean Ministry of Health, Santiago.
At the time of the study, Jennifer Harris Requejo and Flavia Bustreo were with the Partnership for Maternal, Newborn, and Child Health, Geneva, Switzerland.
Jyh Kae Nien is with the Center for Perinatal Diagnosis, Pontificia Catholic University of Chile.
Mario Merialdi and Ana Pilar Betran are with the Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.

American Journal of Public Health -  AJPH 1220-1226 - July 2009, Vol 99, No. 7

Website: http://www.ajph.org/cgi/content/abstract/99/7/1220?etoc  

Objectives. We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions.

Methods. Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4 000 000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles.

Results. During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100 000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile.

Conclusions. During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions.

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