Time-trends in infant mortality rates in the southern Europe
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abstract
Infant Mortality Rate (IMR) has been considered an
important health indicator in monitoring quality of health care.
Objectives: To examine trends in IMR in Southern Europe (SE) over
the last two decades.
Methods: Number of live births and infant deaths reported for SE
(Portugal, Italy, Greece and Spain) between 1990 and 2013 were
abstracted from World Health Organization Database. Annual IMR
per 1,000 live births was computed for each country and for SE
as a whole. Joinpoint regression models were used to estimate
average annual percent change (AAPC) in IMR and respective 95%
Conidence Interval (95% CI) and to identify points in time when
signiicant changes in trend occurred (joinpoints).
Results: Between 1990 and 2013, IMR signiicantly decreased from
9.2 to 3.4 in SE and the highest decrease was observed from 1992 to
1998 (AAPC = -6.1%; 95%CI: -6.5%; -5.8%). Signiicant decline in IMR
was observed in all countries but the pattern was different across
countries. IMR varied across countries between 11.5 and 8.3 and
between 3.1 and 3.8 in 2013; highest IMR were observed in Portugal
for 1990 and in Greece for 2013. Most notable decreases in IMR
were observed from 1990 to 1995 in Portugal (AAPC = -8.4% 95%CI:
-8.8; -8.1), from 1993 to 1997 in Italy (AAPC = -6.6% 95%CI: -7.8;
-5.5) from 1998 to 2006 in Greece (AAPC = -6.8% 95%CI: -7.0; -6.5),
and from 1993 to 1996 in Spain (AAPC = -7.3% 95%CI: -9.0; -5.6).
Decreases in IMR were signiicant during all time period in Italy and
Greece but in Portugal and Spain IMR became unchangeable after
2010-2011.
Conclusions: Decrease in IMR in countries of SE suggests steadily
improvement in the quality of health care. However differences
in the pattern of decrease across countries during the last years
deserve particular attention.
