Spatial Access Matters: An Analysis of Policy Change and Its Effects on Avoidable Infant Mortality in Portugal

Morgan Weiland, Paula Santana, Claudia Costa, Julia Doetsch and Eva Pilot
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Morgan Weiland: Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences (FHML), Care and Public Health Research Institute (CAPHRI), Maastricht University, 6220 MD Maastricht, The Netherlands
Paula Santana: Centre of Studies in Geography and Spatial Planning (CEGOT), University of Coimbra, 3004-531 Coimbra, Portugal
Claudia Costa: Centre of Studies in Geography and Spatial Planning (CEGOT), University of Coimbra, 3004-531 Coimbra, Portugal
Julia Doetsch: Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences (FHML), Care and Public Health Research Institute (CAPHRI), Maastricht University, 6220 MD Maastricht, The Netherlands
Eva Pilot: Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences (FHML), Care and Public Health Research Institute (CAPHRI), Maastricht University, 6220 MD Maastricht, The Netherlands

IJERPH, 2021, vol. 18, issue 3, 1-18

Abstract: 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.

Keywords: avoidable infant mortality; spatial inequalities; healthcare access; maternity unit; healthcare service; Portugal (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:3:p:1242-:d:489961

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