Unequal development in Public Health

Abstract

We analyze the evolution of maternal and infant mortality indicators in Argentina for the period 2000-2005. It can be seen that there is not a simultaneous improvement in all of them and even that improvements in some may be accompanied by stagnation or deterioration in others. Furthermore, the good level reached by some indicators is not enough to prevent their eventual deterioration. Although overall maternal mortality for the country shows a slight improvement, it still constitutes a serious problem in backward areas. Although poor health in women correlates with poverty, the search for a regional typology indicates that the problem goes beyond it. Tierra del Fuego is above the national mean for maternal mortality due to direct obstetrical causes. The provinces of Mendoza, Santa Fe and Río Negro, have a mean value below the national media but the indicator for mortality due to indirect obstetrical causes is above it. The value of the indicators of maternal mortality in provinces with a high per capita product poses questions as to the uncertain results achieved by the health services. In the final section, we have sought to determine the frequency distribution of the output of the public health network in the Province of Misiones (primary level centers and hospitals) , and to analyze the utilization of available facilities for some degree of correlation between services output and maternal and infant mortality rates. Results so far have only confirmed that infant mortality and the rate of use of external consultations are related, as can be seen in the Southern region, which exhibits the highest consultation rate and lowest infant mortality. Something similar occurs in the case of infant mortality for children 1-4 years of age and the consultation rates of sanitary regions. However, this has proved to lack no statistical significance. As regards service output and maternal mortality, no statistically significant relationship was found, save for discharges, but the incidence of these is not clear.