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埃塞俄比亚全国扩大儿童疾病社区治疗后儿童死亡率潜在降低情况的建模

Modeling potential reduction of child mortality after national scale-up of community-based treatment of childhood illnesses in Ethiopia.

作者信息

Pearson Luwei, Hazel Elizabeth, Tam Yvonne

出版信息

Ethiop Med J. 2014 Oct;52 Suppl 3:129-36.

Abstract

BACKGROUND

Since 2010, 28,000 female health extension workers (IEWs) received training and support to provide integrated community based case management (iCCM) of childhood pneumonia, diarrhea, malaria, and se- vere malnutrition in Ethiopia.

OBJECTIVE

We conducted a modeling exercise using two scenarios to project the potential reduction of the under five mortality, riate due io the iCCM program in the four agrarian regions of Ethiopia. METHODS. We created three projections: (1) baseline projection without iCCM; (2) a "moderate" projection using 2012 coverage data scaled up to 30% by 2015 and (3) a "best case" scenario scaled up to 80% with 50% of newborns with sepsis receiving effective treatment by 2015. RESULTS. If the 2012 coverage gains (moderate projection) were applied to the four agrarian regions, we project that the iCCM program could have saved over 10,000 additional lives per year among children age 1-59 months. If iCCM coverage reaches the, "best case" scenario, nearly 80,000 additional lives among children 1-59 months of age would be saved between 2012 and 2015. CONCLUSION. High quality iCCM, delivered and used at scale, is an important contributor to the reduction of under five mortality in rural Ethiopia. Continued investments in iCCM are critical to sustaining and improving recent declines in child mortality.

摘要

背景

自2010年以来,28000名女性健康推广工作者(IEWs)接受了培训并获得支持,以在埃塞俄比亚提供基于社区的儿童肺炎、腹泻、疟疾和重度营养不良综合病例管理(iCCM)。

目的

我们使用两种情景进行了建模分析,以预测埃塞俄比亚四个农业地区因iCCM项目可能降低的五岁以下儿童死亡率。

方法

我们创建了三个预测:(1)无iCCM的基线预测;(2)使用2012年覆盖率数据并在2015年扩大至30%的“适度”预测;(3)到2015年扩大至80%且50%的败血症新生儿接受有效治疗的“最佳情况”情景。

结果

如果将2012年的覆盖率增长(适度预测)应用于四个农业地区,我们预计iCCM项目每年可在1 - 59个月大的儿童中额外挽救超过10000条生命。如果iCCM覆盖率达到“最佳情况”情景,在2012年至2015年期间,1 - 59个月大的儿童中将有近80000条额外生命得以挽救。

结论

大规模提供和使用的高质量iCCM是埃塞俄比亚农村地区降低五岁以下儿童死亡率的重要因素。持续投资于iCCM对于维持和改善近期儿童死亡率的下降至关重要。

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