Subnotificação de óbitos infantis no sistema de informação sobre mortalidade (SIM): uma análise comparativa com o registro dos agentes de saúde

Abstract

lutroduction - The Rate oflnfant Mortality (RIM), it has its calculation harmed at the country, due to a high subnotice of the deaths, that arrives at 66,7% in the Northeast Area. Due to this reality, the Ministry of the Health proposed the “Integration Project among the Information of the System of Information about Mortality (SIM) and the one of the agents' health”, starting from it tooks the Identification and registration of the deaths of children up to one year subnotices. The present work exhibits as it was accomplished this project and its results. Objective - To identify the present subnotice in the System of Information about Mortality (SIM) for the deaths of children up to one year, the year 2000 in Ceará, starting from the agents' health registrations, bcing rescued the excluded infant deaths ofthe systcm and proceeding its registration in the official bank ofmortality. Methodology - To the ransom of the infant deaths subnotices, besides the agents' health information, was uscd complementai informalion of registries, cemeteries, midwives and units of health. The deaths that didn't present a Death’s Declaration (DO), they had made one DO for epidemic ends that later on was incorporated to the SIM. The main cause was only considered, when the information were coming of the medicai record or declared by medicai professional. Otherwise was framed as death without attendance, receiving its appropriate code. Results and Discussion - Children up to one year, 495 deaths was rescued, providing an increase of 15% on the total ofinfant deaths ofthe State. Ofthe rescued deaths, 56% were from the State’s inland, 16% went ofto Metropolitan Area, of Fortaleza, excluding lhe capital and 28% were from Fortaleza. Analyzing for Microrregional of Health, we have that of Maracanaú registered the largest subnotice, with 53% of its infant deaths being rescued by the study. With relationship to the characteristics of the rescued deaths, it was observed that most (52%) it was in thc strip precocious nconatal (<7 days). Considering the period neonatal as a whole (<28 days), it was observed that two thirds of the rescued deaths were of children in this strip of age. Among the defíned causes, stands it out the pre-birth, with the 79% of thc rcgistrations. The final database, with thc inclusion of thc rescued deaths, presented a total of 3.771 infant deaths. The high proportion of home deaths, come as one of the most significant discoveries of the study. About onc of each four infant deaths happened in the children’s own homcs, saine having been before attended by the system of health. Thc Rate Infant Mortality of the State calculated starting from the SIM it was altered, going of children less than one year 22,95 deaths by 1000 bom alive before the ransom, for 26,42/1000 after the ransom. The study suggcsts that SESA incorporates in the agents' health routine the schedule of the study used for the ransom, as well as it promotes training for the municipafs technicians in codc of thc deaths causes, seeking this way better to reduce the big number ofinfant deaths subnotices.