Ester Pablo Viguera, Torres Alberto, Freire José M, Hernández Valentín, Gil Ángel
Department of Preventive Medicine and Public Health, Immunology and Microbiology, University Rey Juan Carlos.
Department of Preventive Medicine, University of Murcia.
J Public Health Afr. 2011 Sep 5;2(2):e27. doi: 10.4081/jphia.2011.e27.
Half of the 10 million children who die annually in the world are from Sub-Saharan Africa (SSA). The reasons are known, but lack of will and resources avoid the development of sustainable policies. Associated factors to the high infant mortality rate (IMR) in SSA have been investigated in this research. An ecological multi-group study was designed comparing rates within SSA. The dependent variable is the IMR and health services, economic and development indicators are the independent variables. Information and data sources were WHO, World Bank, UNICEF and UNDP (1997-2007). IMR mean value is 92.2 (per 1000 live births) and a relationship with several of the factors could be observed. In the bi-variate analysis direct relationship was observed with maternal mortality rate and an inverse relationship was observed with prenatal care coverage, births assisted by skilled health personnel, gross national income per capita, per capita government expenditure on health, social security expenditure, adult literacy rate, net primary school enrolment rate, population with access to safe drinking water (in urban and rural areas) and with population with access to basic sanitation in rural areas. In the multi-variate analysis IMR had an inverse relationship with children under 5 years with diarrhoea who receive oral re-hydration, with social security expenditure as percentage of general government expenditure on health and with per capita government expenditure on health. The situation in SSA would change if their inhabitants received education and information to demand more equitable polices and better investments from their governments.
全球每年有1000万儿童死亡,其中一半来自撒哈拉以南非洲地区(SSA)。原因众所周知,但缺乏意愿和资源阻碍了可持续政策的制定。本研究调查了与SSA地区高婴儿死亡率(IMR)相关的因素。设计了一项生态多组研究,比较SSA地区内部的比率。因变量是IMR,卫生服务、经济和发展指标是自变量。信息和数据来源是世界卫生组织、世界银行、联合国儿童基金会和联合国开发计划署(1997 - 2007年)。IMR平均值为92.2(每1000例活产),并且可以观察到它与几个因素之间的关系。在双变量分析中,观察到与孕产妇死亡率呈直接关系,与产前护理覆盖率、由熟练卫生人员协助分娩、人均国民总收入、政府人均卫生支出、社会保障支出、成人识字率、小学净入学率、(城乡)获得安全饮用水的人口以及农村地区获得基本卫生设施的人口呈反比关系。在多变量分析中,IMR与接受口服补液的5岁以下腹泻儿童、社会保障支出占政府卫生总支出的百分比以及政府人均卫生支出呈反比关系。如果SSA地区的居民接受教育并获得信息,以要求政府制定更公平的政策并进行更好的投资,该地区的情况将会改变。