Bouilly Roberta, Gatica-Domínguez Giovanna, Mesenburg Marilia, Cáceres Ureña Francisco I, Leventhal Daniel G P, Barros Aluísio J D, Victora Cesar G, Wehrmeister Fernando C
Universidad Federal de Pelotas Pelotas Brasil Universidad Federal de Pelotas, Pelotas, Brasil.
Universidad Federal de Ciencias de la Salud Porto Alegre Brasil Universidad Federal de Ciencias de la Salud, Porto Alegre, Brasil.
Rev Panam Salud Publica. 2021 Sep 16;45:e100. doi: 10.26633/RPSP.2021.100. eCollection 2021.
To assess coverage and inequalities in maternal and child health interventions among Haitians, Haitian migrants in the Dominican Republic and Dominicans.
Cross-sectional study using data from nationally representative surveys carried out in Haiti in 2012 and in the Dominican Republic in 2014. Nine indicators were compared: demand for family planning satisfied with modern methods, antenatal care, delivery care (skilled birth attendance), child vaccination (BCG, measles and DPT3), child case management (oral rehydration salts for diarrhea and careseeking for suspected pneumonia), and the composite coverage index. Wealth was measured through an asset-based index, divided into tertiles, and place of residence (urban or rural) was established according to the country definition.
Haitians showed the lowest coverage for demand for family planning satisfied with modern methods (44.2%), antenatal care (65.3%), skilled birth attendance (39.5%) and careseeking for suspected pneumonia (37.9%), and the highest for oral rehydration salts for diarrhea (52.9%), whereas Haitian migrants had the lowest coverage in DPT3 (44.1%) and oral rehydration salts for diarrhea (38%) and the highest in careseeking for suspected pneumonia (80.7%). Dominicans presented the highest coverage for most indicators, except oral rehydration salts for diarrhea and careseeking for suspected pneumonia. The composite coverage index was 79.2% for Dominicans, 69.0% for Haitian migrants, and 52.6% for Haitians. Socioeconomic inequalities generally had pro-rich and pro-urban pattern in all analyzed groups.
Haitian migrants presented higher coverage than Haitians, but lower than Dominicans. Both countries should plan actions and policies to increase coverage and address inequalities of maternal health interventions.
评估海地人、多米尼加共和国的海地移民以及多米尼加人在孕产妇和儿童健康干预措施方面的覆盖情况及不平等现象。
采用横断面研究，数据来自2012年在海地以及2014年在多米尼加共和国开展的具有全国代表性的调查。比较了九项指标：对现代方法满足计划生育需求的情况、产前护理、分娩护理（熟练接生）、儿童疫苗接种（卡介苗、麻疹和三联疫苗）、儿童病例管理（腹泻时口服补液盐及疑似肺炎时的就医情况）以及综合覆盖指数。通过基于资产的指数衡量财富状况，分为三个等级，并根据国家定义确定居住地（城市或农村）。
海地人在对现代方法满足计划生育需求（44.2%）、产前护理（65.3%）、熟练接生（39.5%）以及疑似肺炎就医情况（37.9%）方面的覆盖率最低，而腹泻时口服补液盐的覆盖率最高（52.9%）；海地移民在三联疫苗接种（44.1%）和腹泻时口服补液盐（38%）方面的覆盖率最低，在疑似肺炎就医情况方面的覆盖率最高（80.7%）。多米尼加人在大多数指标上的覆盖率最高，但腹泻时口服补液盐和疑似肺炎就医情况除外。多米尼加人的综合覆盖指数为79.2%，海地移民为69.0%，海地人为52.6%。在所有分析组中，社会经济不平等现象总体上呈现有利于富裕群体和城市群体的模式。
海地移民的覆盖率高于海地人，但低于多米尼加人。两国都应规划行动和政策，以提高覆盖率并解决孕产妇健康干预措施中的不平等问题。
