Aptidão do índice município amigo da primeira infância para discriminar municípios brasileiros quanto à capacidade de promover o desenvolvimento infantil
Data
2023-12-11
Autores
Lima, Luitgard Clayre Gabriel Carvalho de 
Orientadores
Konstantyner, Tulio
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Estimar a aptidão do Índice Município Amigo da Primeira Infância (IMAPI) para discriminar municípios brasileiros quanto à sua capacidade de promover o desenvolvimento infantil. Métodos: Estudo ecológico, descritivo e analítico. Foram estudados todos os 5.570 municípios brasileiros e suas respectivas informações do IMAPI e seus domínios (“Saúde”, “Nutrição”, “Aprendizagem Inicial” e “Segurança e Proteção”), do Índice de Desenvolvimento Humano Municipal-2010 (IDHM-2010) e suas dimensões (Longevidade, Educação e Renda), e de variáveis sociodemográficas de acesso público e livre. Foram descritas as variâncias, medianas, intervalos interquartis e valores máximos e mínimos do IMAPI e seus domínios. Foram estimados os coeficientes de correlação de Spearman (ρ) entre o IMAPI e IDHM-2010, que foram expressos em uma matriz de correlação e de gráficos de dispersão. Adicionalmente, foi criado um painel de especialistas em saúde infantil por meio do método Delphi, que classificaram os 30 indicadores utilizados na elaboração do IMAPI quanto à sua capacidade em promover o desenvolvimento da primeira infância (DPI). Resultados: A mediana do IMAPI foi de 44,0 (IIQ 40,0-48,0). O domínio “Aprendizagem Inicial” apresentou as maiores mediana (69,0; IIQ=59,0-78,0) e variância (159,33) entre os domínios e o IMAPI. O domínio “Segurança e Proteção” apresentou as menores mediana (22,0; IIQ=18,0-26,0) e variância (42,63). Dos 30 indicadores que compõem o IMAPI, 16 (53,3%) foram classificados como aptos a promover o DPI pelo painel de especialistas. Dos indicadores do domínio “Saúde”, onze de 14 (78,6%) foram considerados aptos e dos domínios “Aprendizagem Inicial” e “Segurança e Proteção”, três de sete (42,9%) e dois de cinco (40%), respectivamente. Além disso, nenhum dos quatro indicadores do domínio “Nutrição” foi classificado como apto. Houve correlações positivas e moderadamente fortes do domínio “Aprendizagem Inicial” com as três dimensões do IDHM-2010. Por outro lado, houve correlações negativas e razoáveis entre o domínio “Segurança e Proteção” e as três dimensões do IDHM-2010. Não foi identificada nenhuma correlação muito forte entre o IMAPI e os domínios “Saúde” (ρ=0,614), “Nutrição” (ρ=0,634) e “Aprendizagem Inicial” (ρ=0,647). Especificamente, a correlação entre IMAPI e o domínio “Segurança e Proteção” foi ruim (ρ=0,033) e sem significância estatística. Além disso, este domínio apresentou correlações negativas com o domínio “Aprendizagem Inicial” (ρ=-0,335) e com o IDHM-2010 e suas dimensões. Conclusão: os resultados sugerem que o IMAPI é um indicador conceitualmente promissor quanto à sua intenção de representar o DPI. Entretanto, as variâncias estimadas, as correlações negativas encontradas e a opinião dos especialistas apontam para a necessidade de revisão do significado de parte dos indicadores selecionados, quanto à capacidade de representarem a finalidade a qual se destinam.
Objective: To estimate the aptitude for the Brazilian Early Childhood Friendly Municipal Index (IMAPI) for discriminate Brazilian municipalities in terms of their capacity to promote child development. Methods: Ecological, descriptive and analytical study. The sample was made up of all 5,570 Brazilian municipalities and information from IMAPI and its domains (“Good Health”, “Adequate Nutrition”, “Opportunities for Early Learning” and “Security and Safety”), from the Municipal Human Development Index-2010 (MHDI-2010) and its dimensions (longevity, education and income) and sociodemographic variables of public and free access. Variances, medians, interquartile ranges and maximum and minimum values of IMAPI and its domains were described. Spearman correlation coefficients (ρ) between IMAPI and MHDI-2010 were estimated and expressed in a correlation matrix and scatter plots. Furthermore, a panel of experts in child health was created using the Delphi method, which classified the 30 indicators used in the preparation of IMAPI regarding their ability to promote early childhood development (ECD). Results: The median IMAPI score was 44.0 (IIQ 40.0-48.0). The “Opportunities for Early Learning” domain presented the highest median (69.0; IIQ=59.0-78.0) and variance (159.33) between the domains and the IMAPI. The “Security and Safety” domain presented the lowest median (22.0; IIQ=18.0-26.0) and variance (42.63). Of the 30 indicators that make up IMAPI, 16 (53.3%) were classified as capable of promoting ECD by the panel of experts. Of the 14 indicators in the “Good Health” domain, eleven (78.6%) were considered suitable and in the “Opportunities for Early Learning” and “Security and Safety” domains, three of seven (42.9%) and two of five (40%), respectively. Furthermore, none of the four indicators in the “Adequate Nutrition” domain was classified as suitable. There were positive and moderately strong correlations between the “Opportunities for Early Learning” domain and the three dimensions of the MHDI- 2010. On the other hand, there were negative and reasonable correlations between the “Security and Safety” domain and the three dimensions of the MHDI-2010. No strong correlation was identified between IMAPI and the domains “Good Health” (ρ=0.614), “Adequate Nutrition” (ρ=0.634) and “Opportunities for Early Learning” (ρ=0.647). Specifically, the correlation between IMAPI and the “Security and Safety” domain was poor (ρ=0.033) and without statistical significance. Furthermore, this domain showed negative correlations with the “Opportunities for Early Learning” domain (ρ=-0.335) and with the MHDI-2010 and its dimensions. Conclusions: the results suggest that IMAPI is a conceptually promising indicator regarding its intention to represent ECD. However, the estimated variances, negative correlations and experts' opinions point to the need to review the meaning of part of the selected indicators, in terms of their ability to represent the purpose for which they are intended.
Objective: To estimate the aptitude for the Brazilian Early Childhood Friendly Municipal Index (IMAPI) for discriminate Brazilian municipalities in terms of their capacity to promote child development. Methods: Ecological, descriptive and analytical study. The sample was made up of all 5,570 Brazilian municipalities and information from IMAPI and its domains (“Good Health”, “Adequate Nutrition”, “Opportunities for Early Learning” and “Security and Safety”), from the Municipal Human Development Index-2010 (MHDI-2010) and its dimensions (longevity, education and income) and sociodemographic variables of public and free access. Variances, medians, interquartile ranges and maximum and minimum values of IMAPI and its domains were described. Spearman correlation coefficients (ρ) between IMAPI and MHDI-2010 were estimated and expressed in a correlation matrix and scatter plots. Furthermore, a panel of experts in child health was created using the Delphi method, which classified the 30 indicators used in the preparation of IMAPI regarding their ability to promote early childhood development (ECD). Results: The median IMAPI score was 44.0 (IIQ 40.0-48.0). The “Opportunities for Early Learning” domain presented the highest median (69.0; IIQ=59.0-78.0) and variance (159.33) between the domains and the IMAPI. The “Security and Safety” domain presented the lowest median (22.0; IIQ=18.0-26.0) and variance (42.63). Of the 30 indicators that make up IMAPI, 16 (53.3%) were classified as capable of promoting ECD by the panel of experts. Of the 14 indicators in the “Good Health” domain, eleven (78.6%) were considered suitable and in the “Opportunities for Early Learning” and “Security and Safety” domains, three of seven (42.9%) and two of five (40%), respectively. Furthermore, none of the four indicators in the “Adequate Nutrition” domain was classified as suitable. There were positive and moderately strong correlations between the “Opportunities for Early Learning” domain and the three dimensions of the MHDI- 2010. On the other hand, there were negative and reasonable correlations between the “Security and Safety” domain and the three dimensions of the MHDI-2010. No strong correlation was identified between IMAPI and the domains “Good Health” (ρ=0.614), “Adequate Nutrition” (ρ=0.634) and “Opportunities for Early Learning” (ρ=0.647). Specifically, the correlation between IMAPI and the “Security and Safety” domain was poor (ρ=0.033) and without statistical significance. Furthermore, this domain showed negative correlations with the “Opportunities for Early Learning” domain (ρ=-0.335) and with the MHDI-2010 and its dimensions. Conclusions: the results suggest that IMAPI is a conceptually promising indicator regarding its intention to represent ECD. However, the estimated variances, negative correlations and experts' opinions point to the need to review the meaning of part of the selected indicators, in terms of their ability to represent the purpose for which they are intended.