School of Population Health, University of Queensland, Public Health Building, Herston Rd, Herston, Brisbane, QLD 4006, Australia.
Indian J Pediatr. 2012 May;79(5):612-8. doi: 10.1007/s12098-011-0601-z. Epub 2011 Nov 9.
Improvements in child survival to achieve Millennium Development Goal 4 require highly accessible and effective maternal and child health (MCH) services. This article seeks to fill the gap in information for local government in Indonesia about early age mortality and access to appropriate care to inform the evaluation and planning of MCH services.
The Ende Child Mortality Survey (ECMS) was conducted in the district of Ende in Nusa Tenggara Timur (NTT), one of the poorest provinces in Indonesia. The ECMS is a cross-sectional household survey, providing information on child survival, MCH service utilisation, and socio-economic characteristics of the population. Multivariate logistic regression was conducted to examine the association of mortality, health service utilisation and socio-economic variables.
Use of an unskilled birth attendant (45% of births) and giving birth at home are most common among the poorest and least educated women. The children of these women have the highest risk of infant mortality. The infant mortality rate differs greatly by region within Ende. Time to the preferred provider of child health care is longest in regions with the highest under-five mortality risk.
Many women in Ende do not receive vital interventions during labour to reduce infant mortality. The ECMS demonstrates the feasibility in implementing a low cost survey to provide evidence for MCH investments to improve accessibility to appropriate health services and reduce mortality risk.
要实现千年发展目标 4 中儿童生存方面的改善，就需要高度普及和有效的母婴健康（MCH）服务。本文旨在为印度尼西亚地方政府填补有关儿童早期死亡率和获得适当护理的信息空白，为 MCH 服务的评估和规划提供参考。
恩德儿童死亡率调查（ECMS）在印度尼西亚最贫困的省份之一东努沙登加拉省的恩德区进行。ECMS 是一项横断面家庭调查，提供了儿童生存、MCH 服务利用以及人口社会经济特征方面的信息。采用多变量逻辑回归分析死亡率、卫生服务利用和社会经济变量之间的关联。
最贫困和受教育程度最低的妇女中，最常见的是使用非熟练接生员（45%的分娩）和在家分娩。这些妇女的孩子有最高的婴儿死亡率风险。恩德内部的婴儿死亡率存在很大差异。到儿童保健首选提供者的时间在五岁以下死亡率风险最高的地区最长。
恩德的许多妇女在分娩期间没有得到减少婴儿死亡率的重要干预措施。ECMS 证明了实施低成本调查以提供 MCH 投资证据的可行性，以提高获得适当卫生服务的机会并降低死亡率风险。
