Mortalidad infantil: causas y determinantes sociales en municipios fronterizos de Colombia, estudio ecológico de análisis y tendencia
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Mogollón Pastrán, Sonia Carolina
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Trabajo de grado - Maestría
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EspañolFecha de publicación
2016-06-07
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Colombia ha logrado reducir la Mortalidad Infantil (MI), gracias al fortalecimiento de políticas y al desarrollo de estrategias que han contribuido a mejorar determinantes sociales; no obstante, se han ampliado las brechas en algunas regiones y grupos vulnerables. OBJETIVO: Describir la tendencia de la MI, las principales causas registradas y el comportamiento de los determinantes sociales en los municipios fronterizos de Colombia durante los años 2005 a 2011. METODOLOGÍA: Estudio ecológico de tipo transversal desarrollado en los municipios fronterizos del país a partir información de registros rutinarios, encuestas y estudios de instituciones del Estado y otras de orden internacional. RESULTADOS: El país ha logrado reducir la MI, gracias al fortalecimiento de políticas y al desarrollo de estrategias que han contribuido a mejorar las condiciones de vida de la población, sin embargo, la presente investigación pudo evidenciar la existencia de brechas en el comportamiento de la MI entre departamentos y municipios, y reveló que la mayor carga de MI (Por lo menos un 73%), en municipios frontera, está relacionada con causas consideradas evitables. Por otra parte, permitió tener una aproximación a lo que se podría catalogar como un perfil de riesgo para MI elevada en municipios frontera, que responde a variables relacionadas con la etnia, la raza, la educación, la dependencia infantil, el bajo peso al nacer, la calidad del agua, la ruralidad, la jefatura femenina del hogar, cobertura de vacunación, acceso a controles prenatales, la satisfacción de los usuarios con los servicios de salud y la cobertura de afiliación al sistema de salud. DISCUSIÓN: Los hallazgos del presente estudio sugieren que la dinámica social, económica, ambiental, cultural, política y epidemiológica de los municipios fronterizos es diferente y que dichos aspectos tienen impacto en la MI. El tratamiento homogéneo que los gobiernos han dado a estas regiones, así como, las débiles capacidades de gestión de sus administraciones territoriales, parecen estar acentuado esta problemática en algunos de ellos; ante este escenario y con el propósito de disminuir las brechas existentes entre territorios, es de vital importancia que se realice un ejercicio de armonización de las políticas y planes de salud cuyo fundamento sea la comprensión y abordaje de las necesidades reales de las comunidades, así como, el fortalecimiento de las capacidades de gestión de estas entidades territoriales.
Abstract Colombia has reduced Infant Mortality (IM) by strengthening policies and developing strategies that have helped to improve social determinants; however, the gaps have expanded in some regions and vulnerable groups. OBJECTIVE: To describe the trends of IM, the main registered causes, and social determinants in the border municipalities of Colombia from 2005 to 2011. METHODS: Cross-sectional ecological study developed in the Colombian border municipalities, from routine records, surveys, and other studies from state and international institutions. RESULTS: The country has reduced infant mortality by strengthening policies and developing strategies that have helped to improve the living conditions of the population; however, this research found that there are gaps in IM between the territorial entities and showed that the greatest burden of child mortality (at least 73%) in these municipalities is related to causes considered preventable. On the other hand, this allowed an approximation of what could be named as a risk profile for high IM in the municipalities of the border, regarding variables related to ethnicity, race, education, child dependency, low birth-weight, water quality, rurality, female head of household, vaccination coverage, access to prenatal controls, user satisfaction with health services and coverage of health system affiliation. DISCUSSION: The findings of this study suggest that social, economic, environmental, cultural, political and epidemiological dynamic of the border municipalities is different, and these aspects are related to the distribution the IM. The homogeneous treatment that governments have given to the border regions, as well as the weak capacity in management of the local entities, seem to accentuate issues such as IM in some of them. In this scenario, and in order to reduce the gaps between regions, it is very important to perform an exercise harmonizing policies and health plans whose basis would be understanding and addressing the real needs of the communities, as well as strengthening the management capabilities of the local entities.
Abstract Colombia has reduced Infant Mortality (IM) by strengthening policies and developing strategies that have helped to improve social determinants; however, the gaps have expanded in some regions and vulnerable groups. OBJECTIVE: To describe the trends of IM, the main registered causes, and social determinants in the border municipalities of Colombia from 2005 to 2011. METHODS: Cross-sectional ecological study developed in the Colombian border municipalities, from routine records, surveys, and other studies from state and international institutions. RESULTS: The country has reduced infant mortality by strengthening policies and developing strategies that have helped to improve the living conditions of the population; however, this research found that there are gaps in IM between the territorial entities and showed that the greatest burden of child mortality (at least 73%) in these municipalities is related to causes considered preventable. On the other hand, this allowed an approximation of what could be named as a risk profile for high IM in the municipalities of the border, regarding variables related to ethnicity, race, education, child dependency, low birth-weight, water quality, rurality, female head of household, vaccination coverage, access to prenatal controls, user satisfaction with health services and coverage of health system affiliation. DISCUSSION: The findings of this study suggest that social, economic, environmental, cultural, political and epidemiological dynamic of the border municipalities is different, and these aspects are related to the distribution the IM. The homogeneous treatment that governments have given to the border regions, as well as the weak capacity in management of the local entities, seem to accentuate issues such as IM in some of them. In this scenario, and in order to reduce the gaps between regions, it is very important to perform an exercise harmonizing policies and health plans whose basis would be understanding and addressing the real needs of the communities, as well as strengthening the management capabilities of the local entities.