Lamb W H, Foord F A, Lamb C M, Whitehead R G
Lancet. 1984 Oct 20;2(8408):912-4. doi: 10.1016/s0140-6736(84)90664-0.
As an adjunct to the general nutrition research programme, the MRC Dunn Nutrition Unit has provided for the past 10 years a continuous medical service to three adjacent rural Gambian villages. There have been substantial reductions in annual childhood mortality rates. Perinatal mortality fell from 109.6 to 45.5 per 1000 births, infant mortality from 148.5 to 24.5 per 1000 live births, and mortality in children aged 1-4 years from 109.1 to 13.3 per 1000. There have been no pregnancy-related maternal deaths in the community for 8 years; 16 could have been expected given current estimates of maternal mortality elsewhere in rural Gambia. Of all the health and nutritional interventions introduced the single most important factor has apparently been the on-the-spot, 24 h availability of a physician or qualified midwife.
作为一般营养研究项目的附属部分，英国医学研究委员会邓恩营养部在过去10年里一直为冈比亚农村相邻的三个村庄提供持续的医疗服务。儿童年死亡率大幅下降。围产期死亡率从每1000例出生109.6例降至45.5例，婴儿死亡率从每1000例活产148.5例降至24.5例，1至4岁儿童死亡率从每1000例109.1例降至13.3例。该社区8年来没有与妊娠相关的孕产妇死亡；按照冈比亚农村其他地区目前的孕产妇死亡率估计，本可预期有16例死亡。在所有引入的健康和营养干预措施中，最关键的单一因素显然是有一名医生或合格助产士随时提供24小时现场服务。
