SPACE-TEMPORAL DYNAMICS AND FACTORS ASSOCIATED WITH NEWBORN MORTALITY

INTRODUCTION Neonatal mortality (NM) is the death of children up to 28 days old and is considered one of the most sensitive indicators for assessing access to health services and the quality of care provided to pregnancy, childbirth and the newborn (NB).1 Over the last few decades, infant mortality in Brazil has fallen significantly, mainly due to the reduction in post-neonatal mortality (28 days to one year of age), which is attributed to the improvement in the socio-economic and health conditions of the population.2 On the other hand, neonatal mortality has shown an insignificant reduction and is the main component of mortality in the first year of life, since it is responsible for around 70% of deaths in this age group.3 Neonatal mortality shows significant disparities between Brazilian regions, with the North and Northeast having the highest rates compared to the South and Southeast. [...]it should be noted that most northeastern states have high neonatal mortality rates, including Piaui, which had 9.2 deaths per 1,000 livebirths in 2020.4,5 In this context, there is a need to analyze the distribution of neonatal mortality over time and space and the factors associated with its occurrence, considering that the findings can give visibility to the problem and provide information to managers for decision-making aimed at implementing actions and strategic planning to improve the quality of and access to health services, especially maternal and child services. From this perspective, ecological studies are of great interest, as they allow for the identification of areas at greater risk and in need of monitoring, making it possible to identify atypical patterns in the evolution of mortality levels and in the structure of its causes.6 In view of the above, this study aims to analyze the spatial and temporal distribution of neonatal mortality, as well as the factors associated with its occurrence in the state of Piaui between 2007 and 2017. [...]the regression model was not adjusted for the entire state of Piaui, but only for the municipalities that proved to be statistically significant clusters of neonatal deaths in the Scan spatial statistical technique. [...]of the 224 municipalities in Piaui, 17 were part of the most likely primary cluster and 16 of the cluster considered secondary, totaling 33 municipalities included in the analysis.