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挺过最初五年:斯里兰卡儿童死亡率的经济和医疗决定因素

Surviving the first five years: the economic and healthcare determinants of child mortality in Sri Lanka.

作者信息

Rajapakse Vageesha, Jayathilaka Ruwan

机构信息

SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka.

出版信息

J Health Popul Nutr. 2025 Jun 21;44(1):218. doi: 10.1186/s41043-025-00862-x.

Abstract

BACKGROUND

This study investigates the role of economic growth, healthcare investment, immunization coverage, and malnutrition in reducing under-five mortality rates (U5MR) in Sri Lanka. Understanding how these factors interact within socio-economic ecosystems is essential to formulating sustainable strategies to improve child survival outcomes.

METHODS

This study employs multiple linear regression to analyze the statistical associations between economic growth, healthcare investment, immunization, malnutrition, and under-five mortality in Sri Lanka. Using secondary data from the World Bank and UNICEF (2000-2021), U5MR was modeled against economic growth (per capita GDP), government healthcare expenditure (GHE), immunization coverage (DTP1), and malnutrition (MLN), with significance assessed through p-values and model fit via R².

RESULTS

The multiple linear regression model demonstrated strong explanatory power, accounting for 85% of the variation in under-five mortality (R² = 0.85). Economic growth and immunization coverage were negatively associated with U5MR and found to be statistically significant (p < 0.05 and p < 0.10 respectively), indicating their potential role in reducing child mortality. Malnutrition showed a strong positive association (p < 0.01), emphasizing its continued threat to child health. Although government healthcare expenditure had a negative association, it was not statistically significant, suggesting possible inefficiencies in resource utilization.

CONCLUSION

The study highlights the significant role of economic growth, healthcare expenditure, immunization coverage, and nutrition in shaping U5MR trends in Sri Lanka. The findings emphasize the need for targeted policy interventions to enhance child health outcomes and ensure sustainable progress in reducing child mortality.

摘要

背景

本研究调查了经济增长、医疗保健投资、免疫接种覆盖率和营养不良在降低斯里兰卡五岁以下儿童死亡率(U5MR)方面的作用。了解这些因素在社会经济生态系统中的相互作用方式对于制定改善儿童生存结果的可持续战略至关重要。

方法

本研究采用多元线性回归分析经济增长、医疗保健投资、免疫接种、营养不良与斯里兰卡五岁以下儿童死亡率之间的统计关联。利用世界银行和联合国儿童基金会(2000 - 2021年)的二手数据,以五岁以下儿童死亡率为因变量,以经济增长(人均国内生产总值)、政府医疗保健支出(GHE)、免疫接种覆盖率(DTP1)和营养不良(MLN)为自变量建立模型,通过p值评估显著性,通过R²评估模型拟合度。

结果

多元线性回归模型显示出很强的解释力,解释了五岁以下儿童死亡率变化的85%(R² = 0.85)。经济增长和免疫接种覆盖率与五岁以下儿童死亡率呈负相关,且具有统计学显著性(分别为p < 0.05和p < 0.10),表明它们在降低儿童死亡率方面的潜在作用。营养不良呈现出很强的正相关(p < 0.01),强调了其对儿童健康持续构成的威胁。虽然政府医疗保健支出呈负相关,但不具有统计学显著性,表明资源利用可能存在效率低下的问题。

结论

该研究突出了经济增长、医疗保健支出、免疫接种覆盖率和营养在塑造斯里兰卡五岁以下儿童死亡率趋势方面的重要作用。研究结果强调需要有针对性的政策干预措施,以改善儿童健康结果,并确保在降低儿童死亡率方面取得可持续进展。

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