DSpace Repository

Examining national and district-level trends in neonatal health in Peru through an equity lens: a success story driven by political will and societal advocacy

Show simple item record

dc.contributor.author Huicho Oriundo, Luis
dc.contributor.author Huayanay Espinoza, Carlos Andrés
dc.contributor.author Herrera-Perez, Eder
dc.contributor.author Nino-de-Guzman, Jessica
dc.contributor.author Rivera Chira, Maria Concepcion
dc.contributor.author Restrepo-Mendez, Maria-Clara
dc.contributor.author Barros, Aluisio-J. D.
dc.date.accessioned 2019-02-06T14:45:35Z
dc.date.available 2019-02-06T14:45:35Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5088
dc.description.abstract BACKGROUND: Peru has impressively reduced its neonatal mortality rate (NMR). We aimed, for the period 2000-2013, to: (a) describe national and district NMR variations over time; (b) assess NMR trends by wealth quintile and place of residence; (c) describe evolution of mortality causes; (d) assess completeness of registered mortality; (e) assess coverage and equity of NMR-related interventions; and (f) explore underlying driving factors. METHODS: We compared national NMR time trends from different sources. To describe NMR trends by wealth quintiles, place of residence and districts, we pooled data on births and deaths by calendar year for neonates born to women interviewed in multiple surveys. We disaggregated coverage of NMR-related interventions by wealth quintiles and place of residence. To identify success factors, we ran regression analyses and combined desk reviews with qualitative interviews and group discussions. RESULTS: NMR fell by 51 % from 2000 to 2013, second only to Brazil in Latin America. Reduction was higher in rural and poorest segments (52 and 58 %). District NMR change varied by source. Regarding cause-specific NMRs, prematurity decreased from 7.0 to 3.2 per 1,000 live births, intra-partum related events from 2.9 to 1.2, congenital abnormalities from 2.4 to 1.8, sepsis from 1.9 to 0.8, pneumonia from 0.9 to 0.4, and other conditions from 1.2 to 0.7. Under-registration of neonatal deaths decreased recently, more in districts with higher development index and lower rural population. Coverage of family planning, antenatal care and skilled birth attendance increased more in rural areas and in the poorest quintile. Regressions did not show consistent associations between mortality and predictors. During the study period social determinants improved substantially, and dramatic out-of-health-sector and health-sector changes occurred. Rural areas and the poorest quintile experienced greater NMR reduction. This progress was driven, within a context of economic growth and poverty reduction, by a combination of strong societal advocacy and political will, which translated into pro-poor implementation of evidence-based interventions with a rights-based approach. CONCLUSIONS: Although progress in Peru for reducing NMR has been remarkable, future challenges include closing remaining gaps for urban and rural populations and improving newborn health with qualified staff and intermediate- and intensive-level health facilities. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Public Health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Advocacy en_US
dc.subject Equity en_US
dc.subject Evidence-based interventions en_US
dc.subject Neonatal mortality en_US
dc.subject Policy and system analysis en_US
dc.subject Success factors en_US
dc.subject Adult en_US
dc.subject Family Planning Services/statistics & numerical data en_US
dc.subject Female en_US
dc.subject Housing en_US
dc.subject Humans en_US
dc.subject Infant en_US
dc.subject Infant Health/statistics & numerical data en_US
dc.subject Infant Mortality/trends en_US
dc.subject Infant, Newborn en_US
dc.subject Infant, Premature en_US
dc.subject Peru/epidemiology en_US
dc.subject Pregnancy en_US
dc.subject Prenatal Care/statistics & numerical data en_US
dc.subject Residence Characteristics/statistics & numerical data en_US
dc.subject Rural Population en_US
dc.title Examining national and district-level trends in neonatal health in Peru through an equity lens: a success story driven by political will and societal advocacy en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12889-016-3405-2
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05
dc.relation.issn 1471-2458

Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

info:eu-repo/semantics/restrictedAccess Except where otherwise noted, this item's license is described as info:eu-repo/semantics/restrictedAccess

Search DSpace


My Account