Spatial Access Matters: An Analysis of Policy Change and Its Effects on Avoidable Infant Mortality in Portugal.
Morgan WeilandPaula SantanaClaudia Henrique da CostaJulia DoetschEva PilotPublished in: International journal of environmental research and public health (2021)
In 2006, a policy reform restructured the maternal and perinatal healthcare system, including closing smaller maternity units, to further improve care in Portugal. This study aimed to investigate the effects of the 2006 National Program of Maternal and Neonatal Health policy on spatial inequalities in access to care and consequently avoidable infant mortality. A thematic analysis of qualitative data including interviews and surveys and a quantitative spatial analysis using Geographic Information Systems was applied. Spatial inequalities were found which may lead to avoidable infant mortality. Inequalities exist in freedom of choice and autonomy in care, within a medicalized system. Changes in approach to and organization of care would further enhance equitable spatial access to care in maternal health and reduce avoidable infant mortality.
Keyphrases
- healthcare
- quality improvement
- public health
- palliative care
- mental health
- cardiovascular events
- health information
- birth weight
- pain management
- pregnant women
- machine learning
- cardiovascular disease
- high resolution
- body mass index
- type diabetes
- coronary artery disease
- risk assessment
- weight gain
- health promotion
- chronic pain
- weight loss
- preterm birth