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发展中国家孕产妇死亡率的相关因素:82个国家的生态研究

Correlates of maternal mortality in developing countries: an ecological study in 82 countries.

作者信息

Girum Tadele, Wasie Abebaw

机构信息

Department of Public health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.

出版信息

Matern Health Neonatol Perinatol. 2017 Nov 7;3:19. doi: 10.1186/s40748-017-0059-8. eCollection 2017.

Abstract

BACKGROUND

Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern. With appropriate strategy and intensive implementation programs, some countries have made remarkable progress, however in developing countries where 99% of maternal death is occurring; little or no progress has been made. Identifying determinants and designing intervention will have important role to overcome the problem. Therefore this study aimed to identify correlates of maternal mortality in developing countries.

METHODS

This study was conducted using international data bases of health metrics from 2008 to 2016 using aggregates of health indicator data from WHO, World Bank, UNDP and UNICEF data bases for 82 developing countries. The dependent variable was the maternal mortality ratio, while the independent variable was socio-economic, health care related and morbidity variables. Data was compiled in excel and analyzed using SPSS version 21.

RESULTS

Maternal mortality ratio is very high in developing countries and enormously varies among countries. A significant relationship between the maternal mortality ratio and socio-economic, health care and morbidity indicator variables was observed. There was an inverse and significant correlation of the maternal mortality ratio with Antenatal care coverage, skilled birth attendance, access to an improved water source and sanitation, adult literacy rate, the Gross National Income per capita and positive relation with disease incidence, unmet need and others.

CONCLUSIONS

Maternal mortality is correlated with multiples of socio-economic factors, health care system associated factors, disease burden and their complex interactions. Therefore Policy and programs targeted to improve maternal health and reduce maternal deaths should consider population dynamics, socio-economic influence and health system factors that impose a major risk on mothers.

摘要

背景

孕产妇死亡率因其惊人的规模和较低的下降趋势,成为发展中国家的一个主要公共卫生问题。通过适当的战略和密集的实施方案,一些国家取得了显著进展,然而在99%的孕产妇死亡发生的发展中国家,进展甚微或毫无进展。确定决定因素并设计干预措施对于解决这一问题将发挥重要作用。因此,本研究旨在确定发展中国家孕产妇死亡率的相关因素。

方法

本研究使用2008年至2016年的国际卫生指标数据库,汇总了世界卫生组织、世界银行、联合国开发计划署和联合国儿童基金会数据库中82个发展中国家的卫生指标数据。因变量是孕产妇死亡率,自变量是社会经济、医疗保健相关和发病率变量。数据在Excel中进行整理,并使用SPSS 21版进行分析。

结果

发展中国家的孕产妇死亡率非常高,各国之间差异巨大。观察到孕产妇死亡率与社会经济、医疗保健和发病率指标变量之间存在显著关系。孕产妇死亡率与产前保健覆盖率、熟练接生率、获得改善水源和卫生设施的情况、成人识字率、人均国民总收入呈负相关且显著相关,与疾病发病率、未满足的需求等呈正相关。

结论

孕产妇死亡率与多种社会经济因素、医疗保健系统相关因素、疾病负担及其复杂的相互作用相关。因此,旨在改善孕产妇健康和降低孕产妇死亡的政策和方案应考虑人口动态、社会经济影响以及对母亲构成重大风险的卫生系统因素。

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