PROGRESS OF NEONATAL-MORTALITY IN A METRO POLITAN-AREA OF SOUTHEASTERN BRAZIL FROM 1979 TO 1993 .1. ANALYSIS BY AGE-GROUP ACCORDING TO AREAOF RESIDENCE

The behavior of the infant mortality rate in the State of Rio de Janei ro, Brazil, from 1979 to 1993, is analysed. The annual rate of variati on, calculated as the slope of an exponential regression model, indica tes an overall decreasing trend of approximately 5% per year. Although the neonatal component is also decreasing, the annual rate of variati on is much lower, of only 2,4% per year and is even lower (1,6%) when deaths caused by malnutrition or infectious diseases are not taken int o account. Examining date by region of residence, the area composed of the counties located outside the metropolitan region - called the ''I nterior'' - presents the worst performance. When mortality rates are a nalysed by age-group an interesting pattern is found: the shorter the time of life the lower the value of the rate variation. In contrast to what is found in developed countries, where care is more intensive fo r newborn children, the infant mortality rate in Rio de Janeiro State dedreases less as the number of hours of life approaches the delivery: for the groups of deathas that occurred within the first of life, an increasing trends if found in all of the residencial regions considere d in this. To face this situation, it is necessary to reaffirm the pri orities of the health services, not only in respect to the improvement of the quality of medical assistance but also to the development of s trategies for the epidemiological monitoring of the Brazilian situatio n.