Banca de QUALIFICAÇÃO: DELLIS KARINY FREITAS HOLANDA DE ALMEIDA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : DELLIS KARINY FREITAS HOLANDA DE ALMEIDA
DATE: 30/01/2026
TIME: 13:15
LOCAL: remota
TITLE:

Ecological Study of Maternal Mortality in Brazil in 2023: An Analysis from the Perspective of Intersectionality

KEY WORDS:

KEYWORDS: Maternal Mortality. Intersectional Framework. Public Policy.

PAGES: 32
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Maternal mortality remains a major public health concern and serves as an indicator of structural inequalities that affect women in unequal ways. The intersection of gender, race, ethnicity, educational attainment, and social class demonstrates how women experience differentiated risks, underscoring the need for public policies that are responsive to multiple and overlapping forms of oppression in order to promote equity in healthcare and access to health services. Objective: To analyze maternal mortality in Brazil in 2023 from an intersectional perspective, identifying the social, economic, racial, and gender-related factors associated with this phenomenon. Methods: This ecological observational study used Brazilian states as the units of analysis. The primary outcome was maternal mortality recorded in 2023, obtained from official national health information systems. Data collection and organization were conducted between April and July 2025. Study variables were structured according to the Social Determinants of Health framework and categorized into: proximal determinants (maternal age group, race/skin color, educational attainment, and marital status); intermediate determinants (number of hospitals and healthcare units, place of death, ratio of nurses and physicians per 10,000 inhabitants, access to septic sewage networks, and urban sanitation services); and distal determinants (Gini index, employment and unemployment rates, income, female literacy rate, and social vulnerability index). Quantitative data analysis was performed using R software (version 12), incorporating geoprocessing techniques for spatial analysis. Cluster analysis was applied to identify regional patterns of maternal mortality and social vulnerability across Brazilian states. Indicators were standardized and organized into a Euclidean distance matrix, using the Ward.D2 hierarchical clustering method. Descriptive statistics were calculated to characterize the sociodemographic profiles of the identified clusters. Results: Cluster analysis identified five groups of Brazilian states, revealing marked regional inequalities. The North and Northeast regions concentrated the highest levels of maternal mortality and social vulnerability, whereas the South and Southeast regions presented the most favorable indicators, with the Central-West occupying an intermediate position. Sociodemographic profiles showed a direct association between maternal mortality and social vulnerability. Clusters characterized by higher educational attainment, older maternal age, and a predominance of white women exhibited lower maternal mortality rates. In contrast, clusters marked by lower educational attainment, a higher proportion of mixed-race (parda) and Indigenous women, and early motherhood presented the highest mortality rates. Additionally, five clusters were identified based on the proportion of Black and mixed-race mothers, highlighting racial and regional disparities in maternal profiles. The South and part of the Central-West showed lower proportions of these groups, while the North, Northeast, and Southeast exhibited higher proportions, reflecting Brazil’s racial heterogeneity.

 

COMMITTEE MEMBERS:
Presidente - 1242804 - ADRIANA GOMES MAGALHAES
Interna - 1692571 - ANNA CECILIA QUEIROZ DE MEDEIROS
Interna - 3061300 - LIGIA REJANE SIQUEIRA GARCIA
Externo à Instituição - DAMIAO ERNANE DE SOUZA