OBJECTIVETo identify and analyze factors associated with preventable child deaths.METHODSThis analytical cross-sectional study had preventable child mortality as dependent variable. From a population of 34,284 live births, we have selected a systematic sample of 4,402 children who did not die compared to 272 children who died from preventable causes during the period studied. The independent variables were analyzed in four hierarchical blocks: sociodemographic factors, the characteristics of the mother, prenatal and delivery care, and health conditions of the patient and neonatal care. We performed a descriptive statistical analysis and estimated multiple hierarchical logistic regression models.RESULTSApproximatelly 35.3% of the deaths could have been prevented with the early diagnosis and treatment of diseases during pregnancy and 26.8% of them could have been prevented with better care conditions for pregnant women.CONCLUSIONSThe following characteristics of the mother are determinant for the higher mortality of children before the first year of life: living in neighborhoods with an average family income lower than four minimum wages, being aged ≤ 19 years, having one or more alive children, having a child with low APGAR level at the fifth minute of life, and having a child with low birth weight.

Background The state of São Paulo recorded a significant reduction in infant mortality from 1990 to 2013, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality (considering the neonatal and post-neonatal dimensions) and maternal mortality in the state of São Paulo, Brazil. Methods In this ecological study, data from national official open sources were used to conduct a population-based study. The units analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality (in both neonatal and post-neonatal dimensions) and maternal mortality rates were calculated for every 1000 live births, referring to 2013. Subsequently, the association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. For statistical analysis, we used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted “p” at 5%. Results The increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates. Conclusions It was concluded that the Family Health Care Strategy was a Primary Care organization model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model when planning the organization of Primary Care services for the population.

Objetivo: Aprofundar a temática “Redes de atenção à saúde bucal”, suas dificuldades de implantação e sugestões para sua operacionalização, segundo as percepções de coordenadores de saúde bucal. Métodos: Estudo de natureza qualiquantitativa, realizado com os quatro gestores das cidades, sedes das macrorregiões de saúde do Piauí, que responderam a questões referentes ao tema, sua realidade, dificuldades e sugestões. As respostas foram analisadas através do discurso do sujeito coletivo. Resultados: Os gestores pontuaram possíveis caminhos para a implementação da rede temática da saúde bucal e dificuldades a serem superadas: falta de adequação do setor de saúde às necessidades territoriais, precária estruturação dos níveis de atenção à saúde, insuficiência de recursos humanos e necessidade de maior conhecimento em relação às redes de atenção à saúde. Conclusão: Salienta-se que segundo os gestores inquiridos é possível a operacionalização do eixo temático saúde bucal em um contexto de implantação das Redes de Atenção à Saúde, ao mesmo tempo em que é preciso que sejam considerados os obstáculos assinalados para que seja possível construir os meios de superação dos mesmos.

Conflito de interesses:Os autores declaram não haver nenhum interesse profissional ou pessoal que possa gerar conflito de interesses em relação a este manuscrito.