Search

Providing an enabling nurturing care environment for early childhood development (ECD) that cuts across the five domains of the Nurturing Care Framework (i.e., good health, adequate nutrition, opportunities for early learning, security and safety and responsive caregiving) has become a global priority. Brazil is home to approximately 18.5 million children under 5 years of age, of which 13% are at risk of poor development due to socio-economic inequalities. We explored whether the Early Childhood Friendly Municipal Index (IMAPI) can detect inequities in nurturing care ECD environments across the 5570 Brazilian municipalities. We examined the validity of the IMAPI scores and conducted descriptive analyses for assessing sociodemographic inequities by nurturing care domains and between and within regions. The strong correlations between school achievement (positive) and socially vulnerable children (negative) confirmed the IMAPI as a multidimensional nurturing care indicator. Low IMAPI scores were more frequent in the North (72.7%) and Northeast (63.3%) regions and in small (47.7%) and medium (43.3%) size municipalities. Conversely, high IMAPI scores were more frequent in the more prosperous South (52.9%) and Southeast (41.2%) regions and in metropolitan areas (41.2%). The security and safety domain had the lowest mean differences (MDs) among Brazilian regions (MD = 5) and population size (MD = 3). Between-region analyses confirmed inequities between the North/Northeast and South/Southeast. The biggest within-region inequity gaps were found in the Northeast (from -22 to 15) and the North (-21 to 19). The IMAPI distinguished the nurturing care ECD environments across Brazilian municipalities and can inform equitable and intersectoral multilevel decision making., (© 2021 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

The scope of this article was to estimate the prevalence of severe food insecurity (SFI) in Brazilian municipalities in 2013. A logistic regression model was used to predict SFI. To construct the model, the 2013 National Household Sample Survey (PNAD) was used. SFI was measured using the Brazilian Food Insecurity Scale (EBIA). The final model was applied to the 2010 Census, predicting the municipal prevalence. The highest prevalence values were concentrated in the North and Northeast of Brazil, which also showed the highest municipality prevalence disparities. The highest municipal prevalence value of SFI was in the state of Maranhão and the lowest in Rio Grande do Sul. Maranhão was also the State with the largest intrastate disparities in the prevalence of SFI. Spatial analysis showed a higher prevalence of SFI in the North and Northeast regions. Acre had 100% of its municipalities presenting a very high prevalence of SFI. By contrast in the State of São Paulo, 59.1% of the municipalities have a low prevalence of SFI. The prevalence of municipal SFI was higher in Brazil's North and Northeast and there were major disparities in intraregional and intrastate distribution. These prevalence values could assist in improving the targeting of policies to combat food insecurity in Brazil.