Spatiotemporal Trends in Malnutrition-related Hospitalization and Mortality Among Brazilian Children Under Five

This study investigates annual hospital admissions and deaths due to malnutrition among Brazilian children under five from 2008 to 2024, analyzing spatial and temporal disparities across microregions and states. Using data from Brazil’s Hospital Information System (SIH), we applied a joint Bayesian spatiotemporal model to examine trends and assess five policy scenarios projected through 2030 in the context of Sustainable Development Goal 2 (SDG2): end all forms of malnutrition by 2030. Results reveal persistent regional inequalities, with the North and Northeast bearing the highest burdens, reflecting deep-rooted structural disparities. Key risk factors included pediatric bed availability (RR 1.13, 95% CrI 1.08–1.18), illiteracy, and low income. The National Hospital Care Policy (PNHOSP) contributed to reduced hospitalizations (RR 0.94, 95% CrI 0.89–0.99), but presented a borderline association with higher odds of death (OR 1.26, 95% CrI 0.98–1.58). Projections suggest that, under current conditions, Brazil is unlikely to meet SDG2 by 2030. Targeted investments in pediatric care infrastructure, combined with broader improvements in the social determinants of health, will be essential to mitigate severe malnutrition outcomes and reduce preventable deaths.