Boerma Ties, Tappis Hannah, Saad-Haddad Ghada, Das Jai, Melesse Dessalegn Y, DeJong Jocelyn, Spiegel Paul, Black Robert, Victora Cesar, Bhutta Zulfiqar A, Barros Aluisio J D
Center for Global Public Health, University of Manitoba, Winnipeg, Manitoba, Canada.
Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
BMJ Glob Health. 2019 Jun 24;4(Suppl 4):e001300. doi: 10.1136/bmjgh-2018-001300. eCollection 2019.
Armed conflicts are widespread in sub-Saharan Africa and considered to be an important factor in slowing down national progress in reproductive, maternal, newborn and child health (RMNCH). The measurement of the impact of conflicts on national levels and trends in RMNCH is difficult. National surveys conducted before and sometimes during and after conflicts are a major source of information on the national and local effects of conflicts on RMNCH. We examined data from national surveys in 13 countries in sub-Saharan Africa with major conflicts during 1990-2016 to assess the levels and trends in RMNCH intervention coverage, nutritional status and mortality in children under 5 years in comparison with subregional trends. The surveys provide substantive evidence of a negative association between levels and trends in national indicators of RMNCH service coverage, child growth and under-5 mortality with armed conflict, with some notable exceptions. National surveys are an important source of data to assess the longer term national consequences of conflicts for RMNCH in most countries, despite limitations due to sampling and timing of the surveys.
武装冲突在撒哈拉以南非洲地区广泛存在，被认为是阻碍生殖、孕产妇、新生儿和儿童健康（RMNCH）领域国家发展的一个重要因素。衡量冲突对RMNCH国家层面及趋势的影响颇具难度。在冲突之前、有时在冲突期间及之后开展的全国性调查，是有关冲突对RMNCH产生的国家和地方影响的主要信息来源。我们研究了1990年至2016年期间撒哈拉以南非洲地区13个存在重大冲突国家的全国性调查数据，以评估RMNCH干预措施覆盖率、营养状况以及5岁以下儿童死亡率的水平和趋势，并与次区域趋势进行比较。调查提供了实质性证据，表明RMNCH服务覆盖率、儿童生长发育及5岁以下儿童死亡率等国家指标的水平和趋势与武装冲突之间存在负相关关系，但也有一些显著例外情况。尽管由于调查的抽样和时间安排存在局限性，但全国性调查仍是评估大多数国家冲突对RMNCH产生的长期国家影响的重要数据来源。
