Shimouchi A, Ozasa K, Hayashi K
Kyoto Prefectural University of Medicine, Department of Preventive Medicine, Japan.
Asia Pac J Public Health. 1994;7(4):228-32. doi: 10.1177/101053959400700406.
We examined whether immunization coverage (IMC) is one of the predictors of infant mortality rate (IMR), as a single indicator representing the availability of primary health care (PHC) services in developing countries. Multiple regression analysis showed that partial correlation coefficients for IMR with immunization coverage (-0.224), logarithm of per capita GNP (-0.294), total fertility rate (0.269), and adult literacy rate (-0.325) were all statistically significant (p < 0.001) in 97 developing countries which make up more than 97% of the population in all the developing countries of the world. Multiple correlation coefficients of IMR with these four variables in 97 countries was 0.921. Thus, more than 80% of variation of IMR in developing countries were explained by the variation of the four variables. The study also showed that IMC was well correlated (simple correlation) with the four indicators of the availability of primary health care services; access to local care (0.730), care of pregnant women (0.603), delivery care (0.666), and infant care (0.553), all of which were statistically significant (p < 0.001) in the 48 developing countries which make up 42% of the population of all developing countries. Multiple correlation coefficients of these four variables was 0.787. About 60% of the variation of IMC will be explained by the variation of the four variables. Thus we conclude that immunization coverage is one of the main predictors of the infant mortality rate. It represents one of the health intervention components which can be used as a proxy indicator of the availability of PHC service in developing countries.
我们研究了免疫接种覆盖率（IMC）是否为婴儿死亡率（IMR）的预测因素之一，IMC作为一个单一指标，代表发展中国家初级卫生保健（PHC）服务的可及性。多元回归分析表明，在占世界所有发展中国家人口97%以上的97个发展中国家中，IMR与免疫接种覆盖率（-0.224）、人均国民生产总值对数（-0.294）、总和生育率（0.269）及成人识字率（-0.325）的偏相关系数均具有统计学意义（p<0.001）。97个国家中IMR与这四个变量的复相关系数为0.921。因此，发展中国家IMR超过80%的变异可由这四个变量的变异来解释。该研究还表明，IMC与初级卫生保健服务可及性的四个指标具有良好的相关性（简单相关）；在占所有发展中国家人口42%的48个发展中国家中，获得当地医疗服务（0.730）、孕妇保健（0.603）、分娩护理（0.666）及婴儿护理（0.553），所有这些均具有统计学意义（p<0.001）。这四个变量的复相关系数为0.787。IMC约60%的变异可由这四个变量的变异来解释。因此，我们得出结论，免疫接种覆盖率是婴儿死亡率的主要预测因素之一。它代表了一种卫生干预成分，可作为发展中国家初级卫生保健服务可及性的替代指标。
