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埃塞俄比亚南部加莫戈法地区五岁以下儿童死亡率的社会经济和环境决定因素:一项配对病例对照研究。

Socioeconomic and environmental determinants of under-five mortality in Gamo Gofa Zone, Southern Ethiopia: a matched case control study.

作者信息

Shifa Girma Temam, Ahmed Ahmed Ali, Yalew Alemayehu Worku

机构信息

School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

BMC Int Health Hum Rights. 2018 Feb 27;18(1):14. doi: 10.1186/s12914-018-0153-7.

Abstract

BACKGROUND

Despite global declaration of the right to life as a fundamental human right and substantial progress in reducing childhood mortality, unacceptably high number of children still die before their fifth birthday every day. Different factors have been studied and implicated for under-five mortality with mixed results. Mortality studies in the current study sites were lacking. Therefore, this study examined environmental and socioeconomic determinants of under-five mortality.

METHODS

The study applied a matched case control study design on 381 cases of children who died before their fifth birthday and 762 controls born within 1 month in the same locality as the cases. We conducted weighted conditional logistic regression to assess the association between selected factors and mortality status.

RESULT

The odds of death was found to be significantly lower among children of mothers whose educational status was grade nine or above (Adjusted odds ratio (AOR) of 0.34(0.16-0.72)). The odds of death was significantly higher among children whose mothers' marital status were separated/divorced or widowed (AOR of 3.60(1.23-10.47)) and whose fathers were daily laborers (AOR of 2.34(1.29-4.23)). Presence of separate kitchen in the household for cooking was a proximate factor which was significantly associated with under-five mortality with AOR of 1.77(1.16-2.70).

CONCLUSION

Socioeconomic factors like maternal education, husband occupation and marital status of the mother were shown to be significantly associated with under-five mortality. Hence, in order to enhance reduction in childhood mortality, investing on maternal education targeting those at risk groups is recommended.

摘要

背景

尽管全球宣布生命权是一项基本人权,并且在降低儿童死亡率方面取得了重大进展,但每天仍有数量高得令人无法接受的儿童在五岁前死亡。人们已经对不同因素进行了研究,并认为这些因素与五岁以下儿童死亡率有关,但结果不一。目前的研究地点缺乏死亡率研究。因此,本研究考察了五岁以下儿童死亡率的环境和社会经济决定因素。

方法

本研究采用匹配病例对照研究设计,对381例五岁前死亡的儿童和762例与病例在同一地区出生且出生时间在病例1个月内的对照儿童进行研究。我们进行了加权条件逻辑回归,以评估所选因素与死亡状况之间的关联。

结果

发现母亲教育程度为九年级或以上的儿童死亡几率显著较低(调整后的优势比(AOR)为0.34(0.16 - 0.72))。母亲婚姻状况为分居/离婚或丧偶的儿童(AOR为3.60(1.23 - 10.47))以及父亲为日工的儿童(AOR为2.34(1.29 - 4.23))死亡几率显著较高。家庭中有独立的厨房用于烹饪是一个直接因素,与五岁以下儿童死亡率显著相关,AOR为1.77(1.16 - 2.70)。

结论

母亲教育程度、丈夫职业和母亲婚姻状况等社会经济因素与五岁以下儿童死亡率显著相关。因此,为了进一步降低儿童死亡率,建议针对高危群体投资于母亲教育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3100/5830345/9d9dea73dcf3/12914_2018_153_Fig1_HTML.jpg

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