Análise dos factores associados à mortalidade infanto-juvenil na África Austral: uma aplicação dos modelos de sobrevivência de Cox com fragilidade

Abstract

1.507 / 5.000 Despite global advances in reducing infant and child mortality, it remains a serious public health problem, especially in developing countries and, in particular, in Southern Africa. This study analyzes the factors associated with infant mortality in this region, aiming to identify the variables that influence the probability of children's survival. To this end, data from Demographic and Health Surveys of 13 countries in Southern Africa were used, encompassing different socioeconomic, demographic, and maternal-infant contexts. In order to explore the dynamics of mortality over time, survival analysis was used, with the Cox proportional hazards model with lognormal frailty applied to assess the impact of covariates on survival time and capture the influence of unobservable factors that may affect mortality. The results revealed that female children and those with a higher number of prenatal visits had a reduced risk of death, while twin births, excessive birth weight, and birth intervals of less than 12 months were associated with an increased risk. In short, the study emphasizes the need to strengthen maternal and child health services, promote health education with a family and community approach, strengthen the work of community health teams, and develop intersectoral public policies.