Ferreira, Maria Ângela FernandesMarinho, Cristiane da Silva Ramos2021-10-192021-05-28MARINHO, Cristiane da Silva Ramos. Mortalidade de crianças no Brasil e no Rio Grande do Norte e as políticas públicas. 2021. 110f. Tese (Doutorado em Saúde Coletiva) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2021.https://repositorio.ufrn.br/handle/123456789/44663The mortality of children in Brazil showed a reduction considered in the last years, however, it remains high when compared to developed countries such as Japan, requiring the need to maintain and/or institute interventional measures to control these indices. Added to this, this reduction occurred unevenly between the different regions and Brazilian states, due to the great and important national differences. A macro-regional analysis revealing the Northeast region of Brazil as the one that most reduced under-five child mortality. The state of Rio Grande do Norte reached a reduction of more than 80% in child and the under-five mortality rate in the last four decades. The monitoring of child and the under-five mortality rates provides opportunities for the development of preventive strategies aimed at reducing the risk of death through public policies related to children's health. This thesis aims to analyze child and underfive mortality in Brazil and Rio Grande do Norte, their associated factors and the intervening public policies. Three studies were developed: 1) literature review study about the trajectory of public health and social policies for children in Brazil, from 1973 to 2015. The different strategies, programs and public health and social policies developed over the years were essential to achieve reductions in child and under-five mortality rates in Brazil. In this sense, the National Immunization Program and the creation and institution of the Unified Health System deserve to be highlighted; 2) ecological study using secondary data for Brazil according to Intermediate Urban Linkage Regions from 2001 to 2017. Low income (extreme poverty) in the children’s families and absence of maternal schooling were the variables most closely correlated with underfive mortality rate (r = 0.649, p < 0.001 and r = 0.640, p < 0.001, respectively); 3) a time-series ecological study for 1979 and 2019 was conducted with Rio Grande do Norte as the unit of analysis. The study showed a significant reduce trend between the years 1979 and 2005, APC = -6.13; 95% CI: -6.8; -5.5, for the infant mortality rate, and APC = -5.87; 95% CI: -6.6; -5.1, for the children mortality rate of aged 1 to 4 years. As for the basic causes of death, the complications of pregnancy, childbirth, puerperium / conditions originating in the perinatal period and external causes showed an increasing behavior in the proportionality of infant and children deaths from 01 to 04 years, respectively, over the period studied. Child and under-five mortality rates is directly influenced by public health and social policies, with a stronger impact on the integrated presence of these types of policies, however, being able to change its pattern even in the face of fragmented and / or isolated.Acesso AbertoSaúde da criançaMortalidadePolítica públicadoctoralThesis