Nuruddin R, Kin L Meng, Hadden W C, Azam I
Department of Community Health Sciences, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan.
World Health Popul. 2007;9(3):27-35. doi: 10.12927/whp.2007.19189.
Pakistan ranks fourth globally in terms of absolute numbers of under-5 deaths. Although several determinants of child deaths have been identified, the possibility of an association between mother's health and under-5 deaths has not been assessed in Pakistan. We compared data on 106 deceased children 0-59 months old with those on 3718 live children, using a cross-sectional survey of 2276 households among 99 randomly selected villages in Thatta, a rural district of Pakistan. We examined the association between self-reported maternal health status and under-5 deaths, using the SUDAAN statistical package to account for cluster sampling technique. Three models for logistic regression analysis were Model-1: demographic factors, Model-2: household socio-economic factors and Model-3: demographic and household socio-economic factors. Mothers of deceased children were 60% more likely to report chronic illnesses than mothers of live children after controlling for child's age, mother's age and type of house (final Model-3 analysis) (adjusted odds ratio [aOR; 95% confidence interval]: 1.6 [1.01, 2.5]). The association of self-reported maternal ill health with under-5 deaths in Thatta suggests the role of maternal health in child survival. Child survival strategies should include screening and treating mothers for common chronic illnesses. This is particularly important in a setting where only a quarter of chronically ill mothers seek care outside the home.
就五岁以下儿童死亡的绝对数量而言，巴基斯坦在全球排名第四。尽管已经确定了儿童死亡的几个决定因素，但在巴基斯坦尚未评估母亲健康与五岁以下儿童死亡之间存在关联的可能性。我们在巴基斯坦农村地区塔塔的99个随机选择的村庄中，对2276户家庭进行了横断面调查，比较了106名0至59个月大的死亡儿童与3718名存活儿童的数据。我们使用SUDAAN统计软件包来考虑整群抽样技术，研究了自我报告的母亲健康状况与五岁以下儿童死亡之间的关联。逻辑回归分析的三个模型分别为：模型1：人口统计学因素；模型2：家庭社会经济因素；模型3：人口统计学和家庭社会经济因素。在控制了孩子年龄、母亲年龄和房屋类型后（最终模型3分析），死亡儿童的母亲报告患有慢性病的可能性比存活儿童的母亲高60%（调整后的优势比[aOR；95%置信区间]：1.6[1.01，2.5]）。在塔塔，自我报告的母亲健康状况不佳与五岁以下儿童死亡之间的关联表明了母亲健康在儿童生存中的作用。儿童生存策略应包括对母亲进行常见慢性病的筛查和治疗。在只有四分之一的慢性病母亲会外出就医的情况下，这一点尤为重要。
