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影响孟加拉国新生儿和新生儿后期死亡率的生物人口统计学及就医行为因素:基于人口与健康调查(DHS)数据的证据

Biodemographic and health seeking behaviour factors influencing neonatal and postneonatal mortality in Bangladesh: evidence from DHS data.

作者信息

Rahman Moshiur, Huq Syeda Shahanara

机构信息

Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh.

出版信息

East Afr J Public Health. 2009 Apr;6(1):77-84. doi: 10.4314/eajph.v6i1.45754.

Abstract

This study findings show primarily - amongst the biodemographic and health seeking services factors, delivery-related maternal health complicacies, blindness, higher order births, twin births, lower household size and interaction effect of higher order live births and male child are significantly correlated with higher neonatal mortality. Neonatal deaths are heavily caused by biological, demographical and maternal experience health hazards during/after delivery. The analysis shows that the causes of deaths after neonatal period are deeply rooted in poverty, regional administrative disparity, lack of breastfeeding, unplanned frequency of births, small interval between births and non-utilization of health seeking services. Education, even maternal, and sex differential have no significant effect as what the literature suggested. But the interaction effect of maternal secondary and above education who residing in urban areas has a negative significant association with neonatal mortality. Increased interval between the births significantly reduced the postneonatal but not the neonatal mortality whereas the relationship between the child's birth order and neonatal is found significantly positive. It is suggested that increasing the length of births interval and the duration of breastfeed lowering the frequency of births should decrease the risk of neonatal and postneonatal mortality. Nutrition factor breastfeeding is negatively associated with postneonatal mortality; as duration of breastfeeding increase the postneonate deaths decrease. Results show that the interaction variable of higher order births and the child is boy has moderately significant positive association with neonatal mortality. Postneonates residing in Sylhet have exceptionally higher likelihood of mortality. Although credit for contributing to the lowering of infant mortality has been given to health programs by public health personnel and to the improvement in socio-economic status by social scientists, but in Bangladesh both of these factors are found to influence early childhood mortality. Maternal and child health program as well as public health and nutrition program should be strengthened to provide modern healthcare services to all pregnant women and their infants.

摘要

本研究结果表明,在生物人口学和寻求医疗服务因素、分娩相关的孕产妇健康并发症、失明、多胞胎生育、双胞胎生育、家庭规模较小以及多胞胎活产与男孩的交互作用中,主要因素与新生儿死亡率较高显著相关。新生儿死亡主要是由分娩期间/之后的生物学、人口统计学和孕产妇健康风险导致的。分析表明,新生儿期之后的死亡原因深深植根于贫困、地区行政差异、缺乏母乳喂养、生育计划外频率、生育间隔短以及未利用寻求医疗服务。教育,甚至是孕产妇教育和性别差异,并未如文献所表明的那样产生显著影响。但是,居住在城市地区、受过中等及以上教育的孕产妇的交互作用与新生儿死亡率呈显著负相关。生育间隔增加显著降低了新生儿后期死亡率,但未降低新生儿死亡率,而孩子的出生顺序与新生儿死亡率之间呈显著正相关。建议增加生育间隔长度和母乳喂养持续时间、降低生育频率,应可降低新生儿和新生儿后期死亡风险。营养因素母乳喂养与新生儿后期死亡率呈负相关;随着母乳喂养持续时间增加,新生儿后期死亡人数减少。结果表明,多胞胎生育与孩子为男孩的交互变量与新生儿死亡率呈中度显著正相关。居住在锡尔赫特的新生儿后期婴儿死亡率异常高。尽管公共卫生人员将婴儿死亡率降低归功于卫生项目,社会科学家将其归功于社会经济地位的改善,但在孟加拉国,发现这两个因素都会影响幼儿死亡率。应加强孕产妇和儿童健康项目以及公共卫生和营养项目,为所有孕妇及其婴儿提供现代医疗服务。

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