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巴基斯坦的孕产妇健康问题:实现千年发展目标5的趋势

Issues of maternal health in Pakistan: trends towards millennium development goal 5.

作者信息

Malik Muhammd Faraz Arshad, Kayani Mahmood Akhtar

出版信息

J Pak Med Assoc. 2014 Jun;64(6):690-3.

Abstract

Pakistan has third highest burden of maternal and children mortality across the globe. This grim situation is further intensified by flaws of planning and implementation set forth in health sector. Natural calamities (earth quakes, floods), disease outbreaks and lack of awareness in different regions of country also further aggravate this situation. Despite of all these limitations, under the banner of Millennium Development Goals (MDGs) a special focus and progress in addressing maternal health issue (set as goal 5) has been made over the last decade. In this review, improvement and short falls pertaining to Goal 5 Improve maternal health have been analyzed in relation to earlier years. A decline in maternal mortality ratio (MMR) (490 maternal deaths in 1990 to 260 maternal deaths per 100,000 women in 2010) is observed. Reduction in MMR by three quarters was not achieved but a decline from very high mortality to high mortality index was observed. Increase usage of contraceptives (with contraceptive prevalence rate of 11.8 in 1990 to 37 in 2013) also shed light on women awareness about their health and social issues. Based on progress level assessment (WHO guidelines),access of Pakistani women to universal reproductive health unit falls in moderate category in 2010 as compared to earlier low access in 1990. From the data it looks that still a lot of effort is required for achieving the said targets. However, keeping in view all challenges, Pakistan suffered in the said duration, like volatile peace, regional political instability, policy implementation constrains, population growth, this slow but progressive trend highlight a national resilience to address the havoc challenge of maternal health. These understandings and sustained efforts will significantly contribute a best possible accomplishment in Millennium Development Goal 5 by 2015.

摘要

巴基斯坦是全球孕产妇和儿童死亡率负担第三高的国家。卫生部门规划和实施方面的缺陷进一步加剧了这一严峻形势。自然灾害(地震、洪水)、疾病爆发以及该国不同地区民众缺乏意识也进一步恶化了这种情况。尽管存在所有这些限制,但在千年发展目标(MDGs)的框架下,过去十年在解决孕产妇健康问题(设定为目标5)方面给予了特别关注并取得了进展。在本综述中,已就目标5“改善孕产妇健康”与前些年相关的改善情况和不足之处进行了分析。观察到孕产妇死亡率(MMR)有所下降(从1990年的490例孕产妇死亡降至2010年每10万名妇女中有260例孕产妇死亡)。虽然未实现将孕产妇死亡率降低四分之三的目标,但观察到从极高死亡率降至高死亡率指数。避孕药具使用的增加(避孕药具普及率从1990年的11.8上升至2013年的37)也表明妇女对自身健康和社会问题的意识有所提高。根据进展水平评估(世卫组织指南),与1990年早期较低的可及性相比,2010年巴基斯坦妇女获得普遍生殖健康服务的情况属于中等水平。从数据来看,要实现上述目标似乎仍需付出大量努力。然而,考虑到巴基斯坦在上述期间所面临的所有挑战,如动荡的和平局势、地区政治不稳定、政策实施限制、人口增长等,这种缓慢但渐进的趋势凸显了该国应对孕产妇健康严重挑战的韧性。这些认识和持续努力将极大地有助于在2015年尽可能出色地完成千年发展目标5。

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