Bulatao Rodolfo A, Ross John A
Independent consultant, Silver Spring, MD, USA.
Trop Med Int Health. 2003 Aug;8(8):710-21. doi: 10.1046/j.1365-3156.2003.01083.x.
We report cross-national regressions for maternal mortality in 49 developing countries, using indices of the adequacy of maternal health services derived from ratings by at least 10 experts per country. As in previous such regressions, a socioeconomic factor - in this case per capita income - has a significant effect, but having a trained attendant at delivery does not. Instead, the ratings index for access to services has a consistent, significant effect regardless of which estimates of maternal mortality ratios are predicted. Further analysis suggests that access to treatment for pregnancy complications and to services that help avoid pregnancy and birth are most closely related to lower mortality. Service ratings are interdependent, however, so that focusing only on individual services may not be productive.
我们报告了49个发展中国家孕产妇死亡率的跨国回归情况，使用的是每个国家至少10位专家评级得出的孕产妇保健服务充足性指数。与之前此类回归分析一样，一个社会经济因素——在本案例中为人均收入——具有显著影响，但分娩时有受过培训的护理人员这一因素却没有。相反，无论预测的孕产妇死亡率比率估计值如何，服务可及性评级指数都具有一致的显著影响。进一步分析表明，获得妊娠并发症治疗以及获得有助于避免怀孕和分娩的服务与较低死亡率关系最为密切。然而，服务评级是相互依存的，因此仅关注个别服务可能不会有成效。
