Infant Mortality in Brazil

Abstract

A child’s health is an issue of the very high regard in the public policy agenda in any country, especially the developing countries. Several policies that aim at improving the health of children have seen their implementation over the recent years, with changeable degrees of success. In Brazil, these policies have led to a direct trigger of a significant decline in the rate of infant mortality over the past 30 years. Despite the remarkable development, the mortality rates remain high compared to the various international standards.

Moreover, there a series of significant imbalances in the country that have varied suggestions for the policies that they feel should be adopted. This case presents an analysis of the factors that affect the child's health from an individual perspective and also aims to examine the infant mortality rates while at the same time estimating the dynamic data panels for the periods covering between 1970 and 2000.

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Introduction

Brazil, the largest country in South America, covers 47.3 percent of the South American continent (The World Bank (TWB), 2015). More than half the country is covered with the Amazon Rainforest; the country is filled with a beauty far beyond one’s imagination; however, it is a very poor country with a scarce amount of resources. It is astonishing to know that a country with one of the largest economies faces issues such as poverty, prostitution, and malnutrition.

In comparison to the rest of the countries in the world, Brazil has a strange infant mortality rate. Infant mortality is a serious concern among the population of Brazil and has become more common as the years pass. The Northeast regions of Brazil are the most affected by this epidemic and more than half of the newborns die or do not make it to the age of two().

The total infant mortality rate for Brazil is 14 deaths for every 1,000 live births (TWB), 2015). In the past two years, the number of infant mortality rate has been reduced due to an increase in national volunteers and an increase in Brazil’s public health system.

The worst conditions socially, politically, and health-wise are experienced by the poor population of Brazil, and that significantly impacts the amount of infant mortality in the country. We plan to make an impact in the lives of the target population, women of all ages, and by improving sanitation and providing better maternal education, the infant mortality rate will surely see a decrease in rates (TWB, 2015).

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Language Spoken

The Brazilians are mainly Portuguese speakers, a language spoken by more than 98% of the total population. Some of the minority languages spoken are indigenous while the rest are those spoken by Asian and European immigrants. In total, the languages spoken are approximately 210, 180 making up for the indigenous ones. Notably, there is a big difference between spoken and written Brazilian languages.

Statistics Data

For a long time, infant mortality rates in Brazil, like in any other part of the globe, have been alarming. The rates have however significantly improved over recent decades. According to an online article by Child Fund International, Brazil met the Global Millennium Development Goal (MDG) to lower the death rates of children under the age of five years by 73% by the year 2015. As early as 2011 when out of every one thousand children born alive, only 16 died as compared to 58 in 1990 (ICF, 2016).

The world facts book filed by the Central Interagency Agency (CIA), however, reported a negative movement of the trend. By the year 2015, the mortality rate increased slightly to 18.6 with 21.8 out of every 1,000 male children and 15.23 female children out of every 1,000 born alive, dying (CIA, 2016). According to (WHO, 2015), in Brazil, 46% of infant deaths among children under the age of one month are caused by communicable diseases while for children below one month premature births account for up to 33% of deaths (WHO, 2015).

Consequently, proper parental care, effective breastfeeding as well as good nutrition, and sanitation constitute ways in which communicable diseases, as well as other causes of infant deaths in the nation inclusive of diarrheal ailments, injuries, and pneumonia, may be prevented (Meyers, 2009).

Effective Parental Care

Investment in health care regarding pre and postnatal care is of great essence in establishing the healthy delivery and initial upbringing of a child thus decreasing the chances of them dying as infants. Increased time investment in child care on the part of their parents is said to have a positive correlation with improved neonatal mortality rates (). Research, for example, shows that increased parental leave due to increased parental care substantially reduces infant deaths by up to 1.7% by increasing average birth weight, reducing chances of infant ailments, decreasing probabilities of premature birth, and thus decreasing infant mortality.

Presuming that The Family and Medical Leave Act (FMLA) of 1993 increased the rate of maternity leave-taking among parents a 2013 research by Maya found this fact to be true. The FMLA Act was associated with a 16% increase in maternal leave-taking in the United States (US). For the first month after birth and up to 20% increase in the same during the second month after birth accounted for reduced total infant deaths by at least six deaths per every 10, 000 births (Maya, 2013).

On aggregate, it is thus justified to deduce that effective parental care is key to prevention of the top two causes of infant deaths in Brazil (premature birth for children below one month and communicable diseases for those between one month and five years) (WHO, 2015) as well as any other cause.

The Miracle of Breast Feeding

Consumption, by infants, of human milk, is associated with enhanced health and improved immunity against chronic digestive diseases, diarrhea, and infections of the respiratory system among others (CDC, 2016). As a result, early initiation, as well as limited breastfeeding for a few months after the birth of a child, is highly associated with a decrease in infant deaths (CDC, 2016). According to the United Nations Children Fund, (UNICEF), early and exclusive breastfeeding is the basis of infants’ good nutrition.

Besides, it is equally effective in preventing infections with the potential of reducing mortality by up to 13%. Also, this privilege that few children around the globe get enhances the development of the brain, cognitive abilities as well as child physical development (Maya, 2013). Though exclusive breastfeeding for six months is at the time alleged to cause malnutrition, children that are breastfed have at least six times the chances of surviving as compared to those that are not (WW, 2011).

Proper Nutrition and Sanitation

Poor nutrition is often associated with diseases such as diarrhea, worm infections, and cholera and other than persons living with HIV/AID's infants are the most vulnerable people around the globe to get such infections. Noting that diarrhea is the number one cause of infant death in children between one month and five years in Brazil, nutrition, and sanitation enhancement is thus of paramount importance (CIA, 2016). A report by UNICEF in 2008 showed that 88% of diarrhea-related deaths result from the consumption of contaminated water, lack of proper sanitation, and poor hygiene (UNICEF, 2008).

Malnutrition on the other side constitutes up to 1/3 of global infant deaths (UNICEF, 2013). This results in attributes of poor nutrition such as underweight and vulnerability to common infant ailments inclusive of pneumonia, diarrhea, measles, and malaria (Viellas, 2014). Under-nutrition is often associated with low immunity and thus high frequency and severity of disease contraction leading to higher rates of infant death.

Description of the Program

This program will consider the geographic location, convenient hours of operation, designated groups of health care providers to do home visits and create a mobile clinic. The agenda includes treating and preventing the transmission of diseases due to the lack of proper sanitation like contaminated water, poor hand washing, and sexually transmitting diseases. Also, this program will provide information about appropriate nutrition, the importance of prenatal vitamins, and teaching about smoking and drinking cessation (UNICEF, 2013). Also, this program will provide information about the benefits of breastfeeding. The information will be provided by different methods such as printing materials, physical demonstration, using objects, mannequins, and pictures. Innovativeness

This program is innovative because we are creating a way to bring to the community knowledge and service. The program’s primary goal is to inform as many people as possible and to make sure that they can have an understanding of the importance to create a healthy environment to decrease the rate of infant mortality (UNICEF, 2013).

The information will be provided by visiting pregnant women’s homes, community centers, schools, daycare centers, churches, and local parks. The program will select a group of local people, train them, and provide them with the necessary tools so that they can inform other people and spread out the information in the community. Also, the program will select a group of pregnant women and follow them for three years to better understand their challenges and necessities.

Outcomes of the Program

Short Term Goals

The short-term goal of the program will be to educate women about proper sanitation, breastfeeding, proper nutrition, and prenatal care for the nine months of pregnancy. The short term outcome will be measured from when the woman becomes pregnant until she gives birth which normally takes about nine months.

Long Term Goals of the Project

The long term outcome will be to decrease the rate of infant mortality. This goal will be achieved by following a group of pregnant women during and after their pregnancy (roughly eight months), as well as until the child reaches the age of between three and four years. This monitoring will be conducted every six months to keep track of every step.

Interventions

This program can help provide education to women in rural areas that do not have access to this type of information any other way. The methods of teaching these women will be through brochures so that they may take home, and visual aids such as posters. Local organizations and municipal councils of the area can assist and volunteer with classes of proper nutrition for mother and baby, providing assistance in breastfeeding, providing information on breast milk banks for premature infants, and informing mothers to breastfeed their infant for the first year (UNICEF, 2016).

This program can teach Brazilian women how to make a homemade rehydration drink for infants over six months. This rehydration drink consists of one liter of clean or disinfected water, six leveled teaspoons of sugar and a half leveled teaspoon of salt. This will lower the risk of dying due to dehydration and provide early and appropriate fluid replacement to the infants (Rehydrate.org, 2016). Showing these women how to disinfect water properly will also lower infant mortality by controlling bacteria, viruses, and more resistant organisms, such as the parasites Cryptosporidium and Giardia (Greenland, 2016). The technique used to disinfect water is as follows:

Filter water or allow it to settle, Draw off the clear water, Add half a milliliter (10 drops) of unscented bleach per liter of water; Stir the mixture of water and bleach well; Let it stand for 30 minutes before use. Finally, label and store the disinfected water in clean, sanitized containers with tight covers (CDC, 2016). When correctly implemented, this initiative will see a reduction in infant mortality by 23 percent.

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Approximate Cost

Because of the severity of the situation, it is important that we obtain the proper funding for this program. We estimate that this program will cost approximately 100,000 dollars, which will cover education programs, effective contraception, and provide small clinic outposts in more rural areas for three years. The budget is broken down into four different sections to meet the objectives. The first is water and water treatment followed by birth healthcare and education and finally, the other miscellaneous outcomes.

Timeline of the Project

Given the expansive population in Brazil, this program aims to cover a wide area and thus would take a considerably long period of time. Due to the short timeline given in this project, it was prudent that this project is slated a timeline of 3years so as to provide a comprehensive representation of the dynamics.

The infant mortality rate in Brazil has decreased significantly since the 1990s. When checked in 1990, the rate was 58 deaths for every 1,000 born; this number has dropped now to only 16 (ICF, 2013). This is mainly due to organizations that have already implemented in place interventions to help combat poverty and help increase literacy in rural areas. However, a bigger problem is postnatal care, in which infants also experience a high number of in Brazil.

For our program to work, one of the primary goals would be to get in touch with these organizations that are already suited and familiar with the local population. One of the goals of our program is to help combat problems new mothers face after birth, starting with having better access to healthcare and clean water. Clean water initiatives are already being set up throughout the country. However, our primary goal is to make sure these pipes take place in areas where infant mortality is higher. Our goal is to ensure that this water gets to the mothers to raise their children better.

Since we are not trying to provide water directly, our budget dedicates about 20,000 dollars to the joint effort of providing clean water treatment supplies. Besides, we are investing in source piping water for women to walk less distance to reach this freshwater, as well as educational pamphlets, and volunteers to help show how to treat water effectively to provide to their children.

Our program also aims to help teach and create a system of learning needed to help provide accurate information to the women. Women who have higher literacy and education are less likely to experience infant mortality (Suman, 2013). Our aim is to train and raise women that can help aid in the childbirth process. We also want women to know the importance of prenatal care. In Brazil, prenatal care is highly expensive with an average of about $7,000 in Brazilian currency in 2012 (Elaine, 2014).

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Our program aims to help set up small clinics throughout rural areas that can house the appropriate medications and vitamins for these women. A large chunk of our funding will go to this mission since prenatal care is essential in fetal development. Approximately 40,000 dollars will go to this portion of our project. This is to cover the cost of prenatal care; small shuttles that can help women travel to and from clinic outposts and provide critical birthing classes.

Since this is not the first time Brazil has had problems with infant mortality, we hope to reach out to organizations already “on the ground.” These groups will aid us in learning local customs and helping us get comfortable with the women we wish to help. Church groups and international charities like UNICEF are already active throughout Brazil to help. With a combined budget, we could lower the costs of prenatal care and help these women receive these services freely or for a small fee. Outreach programs will be approximately 10,000 dollars to split amongst the charities with which we are in collaboration.

Other miscellaneous aims of our budget will go towards pamphlets written in the country’s native language, as well as a budget for payment to help further provide incentives for women who are training as doulas for maternal care. It is important that those who after we leave continue to help these women. The cost of this will be 30,000 dollars.

Conclusion

In line with global trends, the rate of infant death in Brazil has significantly decreased over the years. However, there is still a large room for improvement. Since communicable diseases and premature birth account for high levels of infant deaths in the country, measures with the potential for reducing them consequently reduce such rates. Proper nutrition and sanitation, effective breastfeeding, as well as adequate parental care, are thus effective ways of solving the problem of high mortality of children under the age of five. The factors known to contribute immensely to this kind of mortality rate could as well manifest themselves in many ways.

The social impact that befalls mothers of the loss of their child would be huge at any point all over the world. It would not become surprising that these mothers often experience cases of self-deprecation, and by extension, are at a greater risk of getting depressed. It is also most likely that while pregnant, the Brazilian mothers could feel strongly anxious out of their burning concern for their children. In such a country that is experiencing acute poverty and showing a lack of necessary resources, such cases as failed pregnancies can serve as significant economic risks. For a pregnancy to be considered healthy and successful, the prospective mother should have between 25 to 35 pounds of weight gained. This ensures that the developing fetus is well fed and nourished.

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Without this weight in place, it becomes a challenge as the fetus will be at great risk for the undernourishment, mineral deficiency, and vitamins as well as birth defects. To have this weight gain in place, Brazilian mothers ought to eat a lot, balanced diets, and this would demand large sums of money in otherwise poor areas. In effect, if a woman experiences the frequently failed pregnancies, the cost incurred in meeting the extra food necessary to maintain the failed pregnancy becomes exceedingly high.

Politics in the country has also contributed immensely to the rise in infant mortality. The political themes have affected the country to the extent that corruption contributes directly to the dilapidated conditions of the citizens. A case in point, there are reported protests by the people on the demand for accountability for the billions of dollars that the government was alleged to have directed to stadium construction. People expressed their open displeasure about the expenditure of this money; something they felt could be addressed to the elevation of other relevant infrastructure like the health facilities.

The effects of such government decisions on the expectant mothers are quite loud and clear. If a mother who is in labor pain fails to get a hospital or a delivery facility, then it becomes quite a risk. Indeed, the child to be born is at greater risk of mortality. A thorough background of medical research makes the social, political, and economic aspects of the infant mortality rates quite an obvious issue. These issues, when singled out, cannot bear ramified consequences but only do so in combination where they affect both the new-born and their mothers.

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