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Rosana Aquino, MD, PhD, Nelson F. de Oliveira, PhD and Mauricio L. Barreto, MD, PhD

The authors are with the Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil.

Correspondence: Requests for reprints should be sent to Rosana Aquino, Instituto de Saúde Coletiva, Federal University of Bahia, Rua Basílio da Gama, s/n, Canela, CEP. 40.110-140. Salvador, Bahia, Brazil (e-mail: aquino{at}ufba.br).

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.

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