Spatial analysis of maternal mortality

Objective: analyzing, spatially, maternal mortality, identifying areas of risk and potential risk groups. Method: a descriptive, exploratory, retrospective, documentary study with a quantitative approach, based on secondary data obtained at DATASUS. The analyses were performed using the R software and the results provided on graphs, maps and tables. Results: Maranhão, Piauí and Bahia have the highest rates of Maternal Mortality Ratio, but all states had higher mortalities comparing to what is acceptable by the World Health Organization. Regarding the evaluation of the risk of maternal mortality, all states were considered at risk. Conclusion: Northeastern states need health actions to control maternal mortality, to be reassessed, because it was found a high maternal mortality, which increased over the years. Being relevant to the area of greatest risk, in the ten years analyzed, consisted by Bahia, Maranhão and Piauí. Descriptors: Maternal Mortality; Women's Health; Family Health. RESUMO Objetivo: analisar espacialmente a mortalidade materna, identificando áreas de risco, bem como os possíveis grupos de risco. Método: estudo descritivo, exploratório, retrospectivo, documental, com abordagem quantitativa, a partir de dados secundários obtidos no DATASUS. As análises foram realizadas com o software R e os resultados disposto em gráficos, mapas e tabelas. Resultados: o Maranhão, Piauí e Bahia apresentaram os maiores coeficientes da Razão de Mortalidade Materna, mas todos os estados apresentaram mortalidades superiores ao que é aceitável pela Organização Mundial da Saúde. Quanto à avaliação do risco de mortalidade materna, todos os estados foram considerados de risco. Conclusão: os estados do Nordeste necessitam que as ações de saúde para controle da mortalidade materna sejam reavaliadas, pois se constatou alta mortalidade materna, que aumentava com o passar dos anos. Sendo relevante que a área de maior risco, nos dez anos analisados, era composta por Bahia, Maranhão e Piauí. Descritores: Mortalidade Materna; Saúde da Mulher; Saúde da Família. RESUMEN Objetivo: analizar la mortalidad materna espacialmente, identificando áreas de riesgo y potenciales grupos de riesgo. Método: estudio descriptivo, exploratorio, documental y retrospectivo, con enfoque cuantitativo, basado en datos secundarios obtenidos en DATASUS. Los análisis se realizaron utilizando el software R y proporcionaron resultados en gráficos, mapas y tablas. Resultados: Maranhão, Piauí y Bahía tienen las tasas más altas de Razón de Mortalidad Materna, pero todos los estados tenían mayor mortalidad a lo que es aceptable por la Organización Mundial de la Salud. Con respecto a la evaluación del riesgo de la mortalidad materna, se consideraron todos los estados en situación de riesgo. Conclusión: los estados del noreste requieren que las acciones de salud para el control de la mortalidad materna sea reevaluado, pués se constató alta mortalidad materna, que aumentó con los años. Ser relevante para el área de mayor riesgo, en los diez años analizados, consistió en Bahia, Maranhão y Piauí. Descriptores: La Mortalidad Materna; Salud de la Mujer; Salud de la Familia. Nurse, Master’s student, Postgraduate Diploma in Health and Decision Models/PPGMDS, Federal University of Paraíba/UFPB. João Pessoa (PB), Brazil. Email: bruna_lopes1987@yahoo.com.br; Biologist, Doctoral student, Postgraduate in Innovation Therapeutics / PPGIT, Federal University of Pernambuco/UFPE. Recife (PE), Brazil. Email: fredericofavaro@gmail.com; Engineer in electrical production, Professor, Postgraduate Program in Health and Decision Models/PPGMDS. João Pessoa (PB), Brazil. Email: ulissesumbelino@gmail.com; Nurse, Professor Post-Doc, Postgraduate Program in Health and Decision Models/PPGMDS. João Pessoa (PB), Brazil. Email: anaterezaprof@gmail.com ORIGINAL ARTICLE Silva BL da, Ribeiro FF, Anjos UU dos et al. Spatial analysis of maternal mortality. English/Portuguese J Nurs UFPE on line., Recife, 8(Suppl. 1):2287-95, July., 2014 2288 ISSN: 1981-8963 DOI: 10.5205/reuol.5927-50900-1-SM.0807suppl201413 The problem of maternal mortality is evident by reflecting that every minute a woman dies in the world as a result of problems in pregnancy and/or complications in childbirth and the puerperium, and the information that in Brazil, in the period 20002009, the Maternal Mortality Ratio (MMR) was 54,83 deaths per 100 000 live births. Thus, at the end of nine years, there was an increase of 11,92% in maternal mortality in the country, being the Northeast region with the highest MMR. The MMR is an indicator of the health of a population, as well as the level of economic, social and human development; soon, its accompanying and assessment are extremely important for targeting of health to providing its decline as the proposal of the Millennium Declaration to reduce the MMR by three quarters by the year 2015. In order to reduce maternal mortality, Brazilian states, even in the 1990s, should develop actions aimed at women's health or intensify them; however, such practices were only implemented effectively, from the year 2000. Once this period of 10 years (1990-2000) occurred in Brazil, an attempt to develop an adequate for the health needs of women could be seen to influence and, in the near future, in social policy making environment, in structuring a network of health care of women and work process in health, it was important to provide quality care for the pregnant woman and help reduce the MMR. Therefore the achievement of public health efforts focused on women's health only occurs from 2000. The recognition of women's health as a health problem influenced the development of social policies, the development of the health care network of women, as well as in the implementation of health actions that should be in the social-informed health needs of women, however, such events did not allow the reduction of MMR, thereby, Brazil and the Northeast continue to present high MMR. ● Analyzing, spatially, maternal mortality by identifying areas of risk and potential risk groups. A descriptive, exploratory, retrospective, documentary study with a quantitative approach from secondary data obtained from the Department of the SUS (DATASUS) for the Northeastern states, which have a total area of 1.554.257 km, comprising the States of Maranhão/MA, Piauí/IP, Ceará/EC, Rio Grande do Norte/RN, Paraíba/PB, NY/PE, Alagoas/AL, Sergipe/SE and Bahia/BA, which together have a population of 51.871.449 inhabitants, according to the 2010 Census. To obtain data on the site DATASUS, it was followed the steps: 1) Health Information