Child Health and Infant Mortality in Brazil

Child health is a central issue on the public policy agenda of developing countries. Several policies geared to improving child health have been implemented over the years, with varying degrees of success. In Brazil, such policies have led to a significant decline in infant mortality rates over the last 30 years. Despite this improvement, however, mortality rates are still high by international standards and there is substantial variation across Brazilian municipalities, which suggests that differentiated policies should be devised. The aim of this paper is to investigate the determinants of infant mortality at the municipal level, and to provide a more detailed analysis by considering the factors that affect child health at the individual level. To analyze the mortality rate, static and dynamic panel data models are estimated using four censuses covering the period 1970-2000. The demand for child health is addressed through a household decision model, estimated using anthropometric data from the 1996 Standard of Living Survey. The results indicate that sanitation, education and per capita income contributed to the decline in infant mortality in Brazil, the effects being stronger in the long run than in the short run. The fixed effects associated with municipality characteristics help explain the observed dispersion in child mortality rates. The results of the decision model are in line with the mortality model findings: education, sanitation and poverty are the most important explanatory factors of poor child health in Brazil. 1 The authors acknowledge the research assistance of Fabiana Tito, Márcio Diniz, and Daniel Monte. Doracy Brisola provided secretarial assistance. Financial support was provided by the Inter-American Development Bank (IDB), Nemesis, the Pronex Project of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), and the Fundação Instituto de Estudos Econômicos (FIPE).