Impact of the family health program on infant mortality in Brazilian municipalities

Am J Public Health. 2009 Jan;99(1):87-93. doi: 10.2105/AJPH.2007.127480. Epub 2008 Nov 13.


Objectives: We evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level.

Methods: We collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. We performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables.

Results: We observed a statistically significant negative association between FHP coverage and infant mortality rate. After we controlled for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period.

Conclusions: The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities.

MeSH terms

  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Family Health*
  • Female
  • Humans
  • Infant
  • Infant Mortality / trends*
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Models, Statistical
  • Multivariate Analysis
  • Primary Health Care / organization & administration*
  • Program Development
  • Program Evaluation*
  • Regression Analysis
  • Urban Population*