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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.143578v1 99/7/1220    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Gonzalez, R. Articles by Betran, A. P. Search for Related Content PubMed PubMed Citation Articles by Gonzalez, R. Articles by Betran, A. P. Related Collections Health Care Facilities/Services Health Policy Access to Care Other Maternal and Infant Health Public Health Practice Mortality

Rogelio Gonzalez, MD, Jennifer Harris Requejo, PhD, MHS, Jyh Kae Nien, MD, Mario Merialdi, MD, PhD, MPH, Flavia Bustreo, MD, MPH and Ana Pilar Betran, MD, PhD

Rogelio Gonzalez is with Pontificia Catholic University of Chile, Santiago, and the Division of Prevention and Control of Diseases, Chilean Ministry of Health, Santiago. At the time of the study, Jennifer Harris Requejo and Flavia Bustreo were with the Partnership for Maternal, Newborn, and Child Health, Geneva, Switzerland. Jyh Kae Nien is with the Center for Perinatal Diagnosis, Pontificia Catholic University of Chile, Santiago. Mario Merialdi and Ana Pilar Betran are with the Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.

Correspondence: Requests for reprints should be sent to Rogelio Gonzalez, Ministerial adviser in Maternal and Perinatal Health, Department of Disease Prevention and Control, Ministry of Health, McIver 541, Santiago, Chile (e-mail: rogonzalez{at}minsal.gov.cl).

Objectives. We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions.

Methods. Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4 000 000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles.

Results. During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100 000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile.

Conclusions. During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions.