Rougemont A, Arnaud M D, Balique H, Ranque P, Maïti D, Abbaoui S
Soz Praventivmed. 1979 May;24(2-3):143-8. doi: 10.1007/BF02094149.
A retrospective study through questionnaire was made among over 800 women of a Pre-Sahel region of Mali. It confirmed the very high infant and child mortality in this population: over 250% mortality under 1 year of age and over 400% under 6 years of age. The factorial analysis of correspondences proved adequate to determine the main characteristics of the local mortality pattern. In chronological order, the most important causes are obstetrical factors (1st day of life), umbilical tetanus (1 week to 1 month of age), malaria (1 month to 1 year of age), pneumopathies (including pertussis and lung complications of measles), toxicoses and nutritional syndromes (over 1 year of age). Preventive measures at various levels are proposed on the basis of these findings. They belong to three broad groups: -Overall socioeconomic development with effective participation of the rural communities concerned. -Development of an appropriate primary health care structure, with a primary health care team in each village. -Strengthening of the programmes of control of the most important communicable diseases. Such simple and cheap actions should, given a clear political will of the national authorities and a modicum of trust in the future on the part of local leaders, be rapidly implementable even in the most underprivileged countries and bring a significant amount of progress in the rural areas.
通过问卷调查对马里前萨赫勒地区800多名妇女进行了一项回顾性研究。研究证实了该人群中极高的婴幼儿死亡率：1岁以下死亡率超过250%，6岁以下死亡率超过400%。对应分析证明足以确定当地死亡模式的主要特征。按时间顺序，最重要的原因是产科因素（出生第一天）、脐风（1周龄至1月龄）、疟疾（1月龄至1岁）、肺病（包括百日咳和麻疹肺部并发症）、中毒和营养综合征（1岁以上）。基于这些发现提出了各级预防措施。它们分为三大类：- 在相关农村社区有效参与下的总体社会经济发展。- 发展适当的初级卫生保健结构，每个村庄配备一个初级卫生保健团队。- 加强对最重要传染病的控制计划。如果国家当局有明确的政治意愿，地方领导人对未来有一定的信心，那么即使在最贫困的国家，这些简单且成本低廉的行动也应能迅速实施，并在农村地区带来显著进展。
