Koumans E H
Harvard School of Public Health, Harvard Medical School, Boston, Mass.
S Afr Med J. 1992 Feb 15;81(4):202-5.
Childhood mortality rates among rural blacks in South Africa are currently not based on a reliable registration system. National childhood mortality statistics rely on mortality extrapolations and population estimates. This study attempts to provide further information on infant and child mortality among rural blacks in the northern Transvaal, using a direct method. Currently available obstetric histories from hospital and clinic records of the Elim Hospital Health Ward were reviewed, covering the years 1976-1988 and approximately 28,000 pregnancies. The mean infant mortality rate was 88/1,000 live births, and did not change significantly over 10 years, in contrast to other populations in South Africa with documented decreases. Components of the infant mortality rate were also calculated. There was a 1 in 10 risk of death among children less than 5 years of age over this period, although the risk had declined slightly over 10 years. Mortality among boys was higher than that among girls in all age groups studied. Conclusions include that small but measurable changes have occurred in rural South African black childhood mortality rates, although there has been no discernible change in infant mortality, and that a simple direct method can illustrate levels as well as trends in mortality. This has implications for health policy.
目前，南非农村黑人儿童死亡率并非基于可靠的登记系统。全国儿童死亡率统计数据依赖于死亡率推断和人口估计。本研究试图采用直接方法，提供有关德兰士瓦省北部农村黑人婴儿和儿童死亡率的更多信息。对埃利姆医院健康病房1976年至1988年期间医院和诊所记录中的现有产科病史进行了回顾，涵盖约28000例妊娠。平均婴儿死亡率为每1000例活产88例，与南非其他有记录显示死亡率下降的人群相比，10年间没有显著变化。还计算了婴儿死亡率的构成因素。在此期间，5岁以下儿童死亡风险为十分之一，尽管10年间风险略有下降。在所研究的所有年龄组中，男孩的死亡率高于女孩。结论包括，南非农村黑人儿童死亡率虽有微小但可衡量的变化，尽管婴儿死亡率没有明显变化，且一种简单的直接方法可以说明死亡率水平和趋势。这对卫生政策具有启示意义。
