Yale University, 60 College Street, New Haven, CT 06520, United States.
Soc Sci Med. 2011 Jun;72(12):1948-55. doi: 10.1016/j.socscimed.2010.04.038. Epub 2010 May 25.
This article examines the impact of the World Bank's Safe Motherhood Project (SMP) on health outcomes for Indonesia's poor. Provincial data from 1990 to 2005 was analyzed combining a difference-in-differences approach in multivariate regression analysis with matching of intervention (SMP) and control group provinces and adjusting for possible confounders. Our results indicated that, after taking into account the impact of two other concurrent development projects, SMP was statistically significantly associated with a net beneficial change in under-five mortality, but not with infant mortality, total fertility rate, teenage pregnancy, unmet contraceptive need or percentage of deliveries overseen by trained health personnel. Unemployment and the pupil-teacher ratio were statistically significantly associated with infant mortality and percentage deliveries overseen by trained personnel, while pupil-teacher ratio and female education level were statistically significantly associated with under-five mortality. Clinically relevant changes (52-68% increase in the percentage of deliveries overseen by trained personnel, 25-33% decrease in infant mortality rate, and 8-14% decrease in under-five mortality rate) were found in both the intervention (SMP) and control groups.
本文考察了世界银行母婴安全项目（SMP）对印度尼西亚贫困人口健康结果的影响。我们分析了 1990 年至 2005 年的省级数据，采用多元回归分析中的双重差分法，结合干预（SMP）和对照组省份的匹配，并调整了可能的混杂因素。结果表明，在考虑到另外两个同时进行的发展项目的影响后，SMP 与五岁以下儿童死亡率的净有益变化呈统计学显著相关，但与婴儿死亡率、总生育率、青少年怀孕、未满足的避孕需求或受过培训的卫生人员监督的分娩百分比无关。失业率和师生比与婴儿死亡率和受过培训人员监督的分娩百分比呈统计学显著相关，而师生比和女性教育水平与五岁以下儿童死亡率呈统计学显著相关。在干预组（SMP）和对照组中都发现了临床相关的变化（受过培训人员监督的分娩百分比增加 52-68%，婴儿死亡率下降 25-33%，五岁以下儿童死亡率下降 8-14%）。
