School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia.
BMJ Sex Reprod Health. 2020 Oct;46(4):244-253. doi: 10.1136/bmjsrh-2018-200184. Epub 2019 Nov 21.
Current global maternal and child health policies rarely value gender equality or women's rights and are restricted to policies addressing clinical interventions and family planning. Gender equality influences the knowledge, autonomy and utilisation of contraception and healthcare, thereby affecting maternal and child health. This systematic review aims to analyse the concurrent effect of gender equality and contraception on maternal and under-5 child mortality.
A systematic review was conducted to investigate the current evidence. Studies were eligible if three themes-namely, indicators of gender equality (such as female education, labour force participation, gender-based violence), contraception, and maternal or child mortality-were present together in a single article analysing the same sample at the same time.
Even though extensive literature on this topic exists, only three studies managed to fit the selection criteria. Findings of two studies indicated an association between intimate partner violence (IPV) and infant mortality, and also reported that women's contraceptive use increased the risk of IPV. The third study found that the mother's secondary education attainment significantly reduced child mortality, while the mother's working status increased the odds of child mortality. The researchers of all included studies specified that contraceptive use significantly reduced the risk of child mortality.
Improvement in gender equality and contraception concurrently affect the reduction in child mortality. These findings provide strong support to address the research gaps and to include a gender equality approach towards maternal and child health policies.
当前全球母婴健康政策很少重视性别平等或妇女权利,仅限于解决临床干预和计划生育的政策。性别平等影响着避孕和医疗保健的知识、自主性和利用,从而影响母婴健康。本系统评价旨在分析性别平等和避孕对母婴和 5 岁以下儿童死亡率的并发影响。
进行了系统评价以调查当前的证据。如果一项研究同时包含三个主题——性别平等指标(如女性教育、劳动力参与、性别暴力)、避孕和母婴死亡率——并分析同一时间同一样本,则该研究符合入选标准。
尽管关于这个主题有广泛的文献,但只有三项研究符合选择标准。两项研究的结果表明,亲密伴侣暴力(IPV)与婴儿死亡率之间存在关联,并报告称妇女使用避孕药具会增加 IPV 的风险。第三项研究发现,母亲接受中等教育程度显著降低了儿童死亡率,而母亲的工作状况增加了儿童死亡率的几率。所有纳入研究的研究人员都指出,避孕方法的使用显著降低了儿童死亡率的风险。
性别平等和避孕的改善同时影响儿童死亡率的降低。这些发现为解决研究差距和在母婴健康政策中纳入性别平等方法提供了有力支持。