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影响加纳儿童健康的社会因素。

Social Factors Influencing Child Health in Ghana.

作者信息

Quansah Emmanuel, Ohene Lilian Akorfa, Norman Linda, Mireku Michael Osei, Karikari Thomas K

机构信息

Department of Molecular Biology and Biotechnology, School of Biological Science, University of Cape Coast, Cape Coast, Ghana.

Faculty of Health and Life Sciences, De Montfort University, Leicester LE1 9BH, United Kingdom.

出版信息

PLoS One. 2016 Jan 8;11(1):e0145401. doi: 10.1371/journal.pone.0145401. eCollection 2016.

Abstract

OBJECTIVES

Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals' target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal.

METHODS

ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review.

RESULTS

Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence), family income (wealth/poverty) and high dependency (multiparousity). These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices.

CONCLUSIONS

Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother's health knowledge is emphasised.

摘要

目标

社会因素对健康有着深远影响。儿童尤其容易受到社会影响,特别是在其幼年时期。童年时期不良的社会暴露可能导致日后出现慢性疾病。在此,我们试图确定并评估社会因素对加纳儿童健康的影响。鉴于加纳不太可能实现千年发展目标中关于在1990年至2015年间将儿童死亡率降低三分之二的目标,我们认为有必要找出可能导致该目标未能实现的社会决定因素。

方法

我们在科学Direct、PubMed、通过EBSCO的MEDLINE以及谷歌学术上搜索了关于社会因素对加纳儿童健康影响的已发表文章。在对所确定的98篇文章进行筛选后,选取了其中符合我们纳入标准的34篇进行定性综述。

结果

影响该国儿童健康的主要社会因素包括母亲的教育程度、城乡差距(居住地点)、家庭收入(贫富状况)以及高抚养负担(多子女)。这些因素与儿童死亡率、儿童营养状况、免疫规划的完成情况、就医行为和卫生习惯相关。

结论

若干社会因素影响着加纳儿童的健康状况。要针对这些社会决定因素制定更有效的应对措施,需要包括政府、医疗服务提供者和家庭在内的所有利益相关者做出持续努力。我们建议制定干预措施,通过旨在减轻贫困和不平等的直接社会支持举措以及旨在消除不良健康状况对社会因素依赖的间接方法来支持家庭。重要的是,强调扩大优质免费教育干预措施以提高准母亲的健康知识水平。

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