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Comprehending the lack of access to maternal and neonatal emergency care: Designing solutions based on a space-time approach.

Publication ,  Journal Article
Cristina da Silva, N; Rocha, TAH; Amaral, PV; Elahi, C; Thumé, E; Thomaz, EBAF; Queiroz, RCDS; Vissoci, JRN; Staton, C; Facchini, LA
Published in: PLoS One
2020

OBJECTIVE: The objective of this study was to better understand how the lack of emergency child and obstetric care can be related to maternal and neonatal mortality levels. METHODS: We performed spatiotemporal geospatial analyses using data from Brazilian municipalities. An emergency service accessibility index was derived using the two-step floating catchment area (2SFCA) for 951 hospitals. Mortality data from 2000 to 2015 was used to characterize space-time trends. The data was overlapped using a spatial clusters analysis to identify regions with lack of emergency access and high mortality trends. RESULTS: From 2000 to 2015 Brazil the overall neonatal mortality rate varied from 11,42 to 11,71 by 1000 live births. The maternal mortality presented a slightly decrease from 2,98 to 2,88 by 100 thousand inhabitants. For neonatal mortality the Northeast and North regions presented the highest percentage of up trending. For maternal mortality the North region exhibited the higher volume of up trending. The accessibility index obtained highlighted large portions of the rural areas of the country without any coverage of obstetric or neonatal beds. CONCLUSIONS: The analyses highlighted regions with problems of mortality and access to maternal and newborn emergency services. This sequence of steps can be applied to other low and medium income countries as health situation analysis tool. SIGNIFICANCE STATEMENT: Low and middle income countries have greater disparities in access to emergency child and obstetric care. There is a lack of approaches capable to support analysis considering a spatiotemporal perspective for emergency care. Studies using Geographic Information System analysis for maternal and child care, are increasing in frequency. This approach can identify emergency child and obstetric care saturated or deprived regions. The sequence of steps designed here can help researchers, and policy makers to better design strategies aiming to improve emergency child and obstetric care.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2020

Volume

15

Issue

7

Start / End Page

e0235954

Location

United States

Related Subject Headings

  • Spatial Analysis
  • Maternal Mortality
  • Infant Mortality
  • Infant
  • Humans
  • Hospitals
  • Healthcare Disparities
  • Health Services Accessibility
  • General Science & Technology
  • Female
 

Citation

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Cristina da Silva, N., Rocha, T. A. H., Amaral, P. V., Elahi, C., Thumé, E., Thomaz, E. B. A. F., … Facchini, L. A. (2020). Comprehending the lack of access to maternal and neonatal emergency care: Designing solutions based on a space-time approach. PLoS One, 15(7), e0235954. https://doi.org/10.1371/journal.pone.0235954
Cristina da Silva, Núbia, Thiago Augusto Hernandes Rocha, Pedro Vasconcelos Amaral, Cyrus Elahi, Elaine Thumé, Erika Bárbara Abreu Fonseca Thomaz, Rejane Christine de Sousa Queiroz, João Ricardo Nickenig Vissoci, Catherine Staton, and Luiz Augusto Facchini. “Comprehending the lack of access to maternal and neonatal emergency care: Designing solutions based on a space-time approach.PLoS One 15, no. 7 (2020): e0235954. https://doi.org/10.1371/journal.pone.0235954.
Cristina da Silva N, Rocha TAH, Amaral PV, Elahi C, Thumé E, Thomaz EBAF, et al. Comprehending the lack of access to maternal and neonatal emergency care: Designing solutions based on a space-time approach. PLoS One. 2020;15(7):e0235954.
Cristina da Silva, Núbia, et al. “Comprehending the lack of access to maternal and neonatal emergency care: Designing solutions based on a space-time approach.PLoS One, vol. 15, no. 7, 2020, p. e0235954. Pubmed, doi:10.1371/journal.pone.0235954.
Cristina da Silva N, Rocha TAH, Amaral PV, Elahi C, Thumé E, Thomaz EBAF, Queiroz RCDS, Vissoci JRN, Staton C, Facchini LA. Comprehending the lack of access to maternal and neonatal emergency care: Designing solutions based on a space-time approach. PLoS One. 2020;15(7):e0235954.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2020

Volume

15

Issue

7

Start / End Page

e0235954

Location

United States

Related Subject Headings

  • Spatial Analysis
  • Maternal Mortality
  • Infant Mortality
  • Infant
  • Humans
  • Hospitals
  • Healthcare Disparities
  • Health Services Accessibility
  • General Science & Technology
  • Female