[Impact of health care in the reduction of the mortality of cervix neoplasms in the health services].

The importance of health care in the mortality caused by cervical uterine cancer in the age group 30 to 64 years is evaluated in the different health centers, excluding the effect of the quality or level of live in those areas. A model of multiple regression predicts the expected mortality rate according to the economic level of the population served by the health center. The different between the observed and predicted rates (the residual rate) is attributed to health care. Another multiple regression model with health variables checks the direct association between the magnitude of the residual rate and medical gynecological consultations; this variable is related significantly and positively to the number of consultations (patient visits) for general morbidity; specialities and with the numbers of midwives. The higher mortality rate associated with higher morbidity rate reflects defects in programs of early diagnosis and identified five deficitiary services. As the activities realized by midwives (such as prenatal check ups and gynecological consultation) are important and the lack of an inverse relation with the mortality rates shown, it is suggested that the resignation of activities and functions to strengthen secondary prevention of cervical uterine cancer be reviewed and modified.