Bhatia S
Department of Population Dynamics, Johns Hopkins University, Baltimore, MD 21205.
Stud Fam Plann. 1989 May-Jun;20(3):136-46.
Community-level research data from a Maternal-Child Health and Family Planning (MCH/FP) program and comparison areas in rural Bangladesh indicate that 60 percent of infant deaths occurred in the neonatal period in both areas. Since the inception of the MCH/FP program, mortality rates declined relative to those in the comparison area. This decline, however, was confined to the neonatal period death rates only, with mortality rates in the postneonatal period remaining similar in the two areas. Prematurity accounted for approximately 40 percent of deaths in the neonatal period. Cause-of-death data indicated that the differences in the neonatal mortality rates between the two areas was mainly due to a marked decline in tetanus neonatorum deaths in the MCH/FP program area, because of the tetanus toxoid immunization of pregnant women there. The interventions in the MCH/FP area, however, did not significantly influence mortality due to any other cause. This study provides an explanation for the limited impact on infant mortality of health interventions that focus on diarrheal diseases and immunizations of children.
来自孟加拉国农村地区母婴健康与计划生育（MCH/FP）项目及对照地区的社区层面研究数据表明，两个地区60%的婴儿死亡发生在新生儿期。自MCH/FP项目启动以来，相对于对照地区，死亡率有所下降。然而，这种下降仅局限于新生儿期死亡率，两个地区新生儿后期的死亡率仍相似。早产约占新生儿期死亡的40%。死因数据表明，两个地区新生儿死亡率的差异主要是由于MCH/FP项目地区新生儿破伤风死亡显著下降，原因是该地区孕妇接种了破伤风类毒素。然而，MCH/FP地区的干预措施对其他任何原因导致的死亡率没有显著影响。这项研究为侧重于腹泻疾病和儿童免疫的健康干预措施对婴儿死亡率影响有限提供了解释。
