Figure 1
Right: Example of possible randomly generated starting points. Left: Census sector drawn, already with map overlap, delimited by the line, with random starting point signaled by the arrow.
Table 1
Evolution of the content of the questionnaires of the PESMIC’s, 1987–2017.
| Year | 1987 | 1990 | 1994 | 2001 | 2007 | 2017 |
|---|---|---|---|---|---|---|
| Main focus | Child health | Women’s health | Reproductive health | Family health | Maternal and child nutrition | Child development |
| Kids | Age and sex | Age and sex | Age and sex | Age and sex | Age and sex | Age and sex |
| Birth weight | Birth weight | Birth weight | Birth weight | Birth weight | Birth weight | |
| Power supply | Power supply | Power supply | Power supply | Power supply | Power supply | |
| Vaccination | Vaccination | Vaccination | Vaccination | Vaccination | Vaccination | |
| Morbidity: diarrhea, TRO and IRAs | Morbidity: diarrhea, TRO and IRAs | Morbidity: diarrhea, TRO and IRAs | Morbidity: diarrhea, TRO and IRAs | Morbidity: diarrhea, TRO and IRAs | Morbidity: diarrhea, TRO and IRAs | |
| Attend day care | Attend day care | Attend day care | Attend day care | Attend day care | Attend day care | |
| Medical consultations | Medical consultations | Medical consultations | Medical consultations | Medical consultations | Medical consultations | |
| Hospitalization | Hospitalization | Hospitalization | Hospitalization | Hospitalization | Hospitalization | |
| Health agent visits | Health agent visits | Health agent visits | Health agent visits | Health agent visits | Health agent visits | |
| Nutritional evaluation | Nutritional evaluation | Nutritional evaluation | Nutritional evaluation | Nutritional evaluation | Nutritional evaluation | |
| Accidents at home | Accidents at home | |||||
| Evaluation of autism | ||||||
| Early stimulation | ||||||
| Child development measured by ASQ3 | ||||||
| Women | Age | Age | Age | Age | Age | Age |
| Schooling | Schooling | Schooling | Schooling | Schooling | ||
| Prenatal care | Prenatal care | Prenatal care | Prenatal care | Prenatal care | ||
| Childbirth assistance | Childbirth assistance | Childbirth assistance | Childbirth assistance | Childbirth assistance | ||
| Work outside the home | Work outside the home | Work outside the home | Work outside the home | Work outside the home | ||
| Reproductive history | Reproductive history | Reproductive history | Reproductive history | Reproductive history | ||
| Cancer prevention | Cancer prevention | Cancer prevention | Cancer prevention | Cancer prevention | ||
| Family planning | Family planning | Family planning | Family planning | Family planning | ||
| Surgical sterilization | Surgical sterilization | Surgical sterilization | Surgical sterilization | |||
| Gynecological morbidity | Gynecological morbidity | Gynecological morbidity | Gynecological morbidity | |||
| Medical consultations | Medical consultations | Medical consultations | Medical consultations | |||
| Health agent visits | Health agent visits | Health agent visits | Health agent visits | |||
| STDs and AIDS | STDs and AIDS | STDs and AIDS | ||||
| Smoking | Smoking | |||||
| Hypertension and Diabetes | Hypertension and Diabetes | |||||
| Nutritional evaluation | Nutritional evaluation | |||||
| Other forms of morbidity | ||||||
| Maternal Depression | ||||||
| Family | Number of people | Number of people | Number of people | Number of people | Number of people | Number of people |
| Head of the family | Head of the family | Head of the family | ||||
| Education Chief family | Education Chief family | Education Chief family | ||||
| Family income | Family income | Family income | Family income | Family income | Family income | |
| Water and sanitation | Water and sanitation | Water and sanitation | Water and sanitation | Water and sanitation | Water and sanitation | |
| Access to the Family Health Program (PSF) | Access to the Family Health Program (PSF) | Access to the Family Health Program (PSF) | Access to the Family Health Program (PSF) | |||
| Health insurance | Health insurance | Health insurance | Health insurance | |||
| Food security | Food security | |||||
| Cash transfer Program | Cash transfer Program | |||||
| Social adversities | ||||||
| Domestic violence | ||||||
| Presence of toxic stress |
Table 2
Distribution of sample elements of five PESMICSs: households, people resident, women of childbearing age and preschool kids. Ceará, Brazil, 1987 to 2007.
| Years | Households | Residents | Women of 10–49 years | Children 0–3 years | Children from 4–6 years |
|---|---|---|---|---|---|
| 1987 | 8,000 | 39,653 | 10,743 | 4,513 | – |
| 1990 | 8,000 | 31,204 | 8,476 | 2,861 | – |
| 1994 | 8,000 | 35,935 | 9,710 | 2,461 | – |
| 2001 | 7,833 | 35,535 | 9,754 | 1,681 | – |
| 2007 | 7,989 | 34,805 | 8,825 | 1,533 | – |
| 2017 | 3,200 | 13,249 | 3,752 | 2,153 | 1,413 |
| Total | 43,022 | 190,381 | 51,260 | 15,202 | 1,413 |
Table 3
Socioeconomic and demographic characterization families’ participants of PESMICs. Ceará, Brazil, 1987 to 2007.
| Indicator | Years | % change** | P value** | |||||
|---|---|---|---|---|---|---|---|---|
| 1987 | 1990 | 1994 | 2001 | 2007 | 2017 | |||
| % of households with monthly income ≤ 1 minimum wage | 52.5 | 46.5 | 47.3 | 49.4 | 58.1 | 56.1 | +10.7 | <0.001 |
| % of households with potable water availability1 | 25.3 | – | 25.8 | 67.8 | 77.0 | 84.1 | +136.4 | <0.001 |
| % of females literate | 58.4 | 75.1 | 93 | 92.7 | 96.4 | 96.7 | +65.1 | <0.001 |
| % Coverage for measles | 48.2 | 76.3 | 94.4 | 94.9 | 96.7 | 87.2 | +80.9% | <0.001 |
[i] PESMIC = Maternal and Child Health Survey of Ceará.
* Difference between the last and the first measurement.
** Chi-square trend.
1 Piped water and/or mineral water.
Table 4
Pooled data analysis of determinant factor of chronic undernutrition over the 30 years.
| Model Variables* | P value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Fixed | |||||||||||||
| Year | 1987 | 1987 | 1990 | 1990 | 1994 | 1994 | 2001 | 2001 | 2007 | 2007 | 2017 | 2017 | |
| Main city or Country town | Main city | Country town | Main city | Country town | Main city | Country town | Main city | Country town | Main city | Country town | Main city | Country town | |
| Dependent | |||||||||||||
| Height for age | 2.28 | 0.73 | –0.53 | –1.10 | –0.71 | –1.02 | –0.20 | –1.03 | 0.44 | 0.31 | –0.0276 | –0.3814 | |
| Independent | |||||||||||||
| Maternal education | 6.02 | 3.57 | 6.19 | 2.85 | 6.38 | 3.45 | 6.66 | 5.78 | 6.89 | 6.46 | 7.77 | 7.48 | 0.037 |
| Time to weaning from breastfeeding | 2.54 | 2.86 | 3.53 | 5.00 | 5.05 | 6.05 | 6.21 | 6.33 | 6.62 | 7.75 | 9.87 | 9.57 | 0.033 |
| Birth weight | 3,318.83 | 3,399.82 | 3,324.35 | 3,364.51 | 3,227.86 | 3,309.09 | 3,349.34 | 3,317.78 | 3,221.77 | 3,286.98 | 3,254.03 | 3,233.08 | 0.113 |
| Family income | 5.49 | 1.41 | 4.68 | 1.74 | 2.70 | 1.65 | 4.94 | 1.77 | 2.60 | 1.21 | 1.36 | 1.14 | 0.013 |
[i] * Adjustment model measures: Akaike information criteria (AIC) –10,848.
Hurvich and Tsai criterion (AICC) –2,848.
Bozdogan criterion (CAIC) –8,010.
Schwarz’s Bayesian criterion (BIC) –11,010.