Jones Gareth, Steketee Richard W, Black Robert E, Bhutta Zulfiqar A, Morris Saul S
Division of Policy and Planning, United Nations Children's Fund, New York, NY 10017, USA.
Lancet. 2003 Jul 5;362(9377):65-71. doi: 10.1016/S0140-6736(03)13811-1.
This is the second of five papers in the child survival series. The first focused on continuing high rates of child mortality (over 10 million each year) from preventable causes: diarrhoea, pneumonia, measles, malaria, HIV/AIDS, the underlying cause of undernutrition, and a small group of causes leading to neonatal deaths. We review child survival interventions feasible for delivery at high coverage in low-income settings, and classify these as level 1 (sufficient evidence of effect), level 2 (limited evidence), or level 3 (inadequate evidence). Our results show that at least one level-1 intervention is available for preventing or treating each main cause of death among children younger than 5 years, apart from birth asphyxia, for which a level-2 intervention is available. There is also limited evidence for several other interventions. However, global coverage for most interventions is below 50%. If level 1 or 2 interventions were universally available, 63% of child deaths could be prevented. These findings show that the interventions needed to achieve the millennium development goal of reducing child mortality by two-thirds by 2015 are available, but that they are not being delivered to the mothers and children who need them.
这是儿童生存系列五篇论文中的第二篇。第一篇聚焦于可预防原因导致的持续高儿童死亡率(每年超过1000万):腹泻、肺炎、麻疹、疟疾、艾滋病毒/艾滋病、营养不良的根本原因以及导致新生儿死亡的一小部分原因。我们回顾了在低收入环境中可行的、能以高覆盖率提供的儿童生存干预措施,并将其分类为1级(有充分效果证据)、2级(证据有限)或3级(证据不足)。我们的结果表明,除了出生窒息(有2级干预措施)外,对于预防或治疗5岁以下儿童的每种主要死亡原因,都至少有一种1级干预措施可用。对于其他几种干预措施也有有限的证据。然而,大多数干预措施的全球覆盖率低于50%。如果普遍提供1级或2级干预措施,63%的儿童死亡可以预防。这些发现表明,实现到2015年将儿童死亡率降低三分之二这一千年发展目标所需的干预措施是存在的,但这些措施并未提供给有需要的母亲和儿童。
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