Resumen

Introduction: The distribution of health resources influences early neonatal mortality, granting access to obstetric care which is a major public health problem. However, the geographical dimension of this influence has not been studied in Colombia. Objective: To describe the geographical accessibility to obstetric and neonatal care beds and its association with early neonatal mortality in Colombia and its municipalities. Method: An ecological study at municipal level was carried out. Ordinary least squares (OLS) regression and a geographically weighted regression (GWR) were used to explore statistical and spatial associations. Results: The municipalities in Colombia with Higher mortality tend to have lower geographical accessibility to obstetric and neonatal beds after controlling the fertility and economic characteristics of these municipalities. This association is significant only in municipalities of the west coast. The strength of this association decreases in inner municipalities. Discussion: The centralization of obstetric and neonatal beds in major municipalities around the central region leaves municipalities with high risk of mortality underserved. The decentralization of obstetric and neonatal healthcare resources is a mandatory issue in order to reduce geographical disparities in mortality and to improve neonatal survival, and a healthy beginning of life.

Palabras clave: Área sin atención médica disparidades en atención de salud accesibilidad a los servicios de salud servicios de salud materno-infantil mortalidad neonatal precoz análisis espacial.

2018-10-30   |   311 visitas   |   Evalua este artículo 0 valoraciones

Vol. 20 Núm.1. Abril-Julio 2017 Pags. 7-18 MedUNAB 2017; 20(1)