Adeyinka Daniel Adedayo, Petrucka Pammla Margaret, Isaac Elon Warnow, Muhajarine Nazeem
Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Public Health, Federal Ministry of Health, Abuja, Nigeria.
BMJ Open. 2021 Jan 29;11(1):e040302. doi: 10.1136/bmjopen-2020-040302.
In line with the child survival and gender equality targets of Sustainable Development Goals (SDG) 3 and 5, we aimed to: (1) estimate the age and sex-specific mortality trends in child-related SDG indicators (ie, neonatal mortality rate (NMR) and under-five mortality rate (U5MR)) over the 1960s-2017 period, and (2) estimate the expected annual reduction rates needed to achieve the SDG-3 targets by projecting rates from 2018 to 2030.
Group method of data handling-type artificial neural network (GMDH-type ANN) time series.
This study used an artificial intelligence time series (GMDH-type ANN) to forecast age-specific childhood mortality rates (neonatal and under-five) and sex-specific U5MR from 2018 to 2030. The data sets were the yearly historical mortality rates between 1960s and 2017, obtained from the World Bank website. Two scenarios of mortality trajectories were simulated: (1) status quo scenarios-assuming the current trend continues; and (2) acceleration scenarios-consistent with the SDG targets.
At the projected rates of decline of 2.0% for NMR and 1.2% for U5MR, Nigeria will not achieve the child survival SDG targets by 2030. Unexpectedly, U5MR will begin to increase by 2028. To put Nigeria back on track, annual reduction rates of 7.8% for NMR and 10.7% for U5MR are required. Also, female U5MR is decreasing more slowly than male U5MR. At the end of SDG era, female deaths will be higher than male deaths (80.9 vs 62.6 deaths per 1000 live births).
Nigeria is not likely to achieve SDG targets for child survival and gender equities because female disadvantages will worsen. A plausible reason for the projected increase in female mortality is societal discrimination and victimisation faced by female child. Stakeholders in Nigeria need to adequately plan for child health to achieve SDG targets by 2030. Addressing gender inequities in childhood mortality in Nigeria would require gender-sensitive policies and community mobilisation against gender-based discrimination towards female child.
为了符合可持续发展目标（SDG）3和5的儿童生存与性别平等目标，我们旨在：（1）估算20世纪60年代至2017年期间与儿童相关的可持续发展目标指标（即新生儿死亡率（NMR）和五岁以下儿童死亡率（U5MR））的年龄和性别特异性死亡率趋势，以及（2）通过预测2018年至2030年的死亡率来估算实现可持续发展目标3的目标所需的预期年降低率。
数据处理型人工神经网络（GMDH型ANN）时间序列分组方法。
本研究使用人工智能时间序列（GMDH型ANN）来预测2018年至2030年特定年龄的儿童死亡率（新生儿和五岁以下）以及特定性别的U5MR。数据集是20世纪60年代至2017年的年度历史死亡率，从世界银行网站获取。模拟了两种死亡率轨迹情景：（1）现状情景——假设当前趋势持续；（2）加速情景——与可持续发展目标一致。
按照预测的下降率，NMR为2.0%，U5MR为1.2%，尼日利亚到2030年将无法实现儿童生存可持续发展目标。出乎意料的是，U5MR到2028年将开始上升。为使尼日利亚重回正轨，NMR的年降低率需要达到7.8%，U5MR需要达到10.7%。此外，女性U5MR的下降速度比男性U5MR慢。在可持续发展目标时代结束时，女性死亡人数将高于男性（每1000例活产中有80.9例死亡对62.6例死亡）。
尼日利亚不太可能实现儿童生存和性别平等方面的可持续发展目标，因为女性的劣势将加剧。预计女性死亡率上升的一个合理原因是女童面临的社会歧视和伤害。尼日利亚的利益相关者需要为儿童健康制定充分的计划，以在2030年实现可持续发展目标。解决尼日利亚儿童死亡率中的性别不平等问题需要对性别敏感的政策以及针对女童的基于性别的歧视进行社区动员。
