Díez E, Villalbí J R, Benaque A, Nebot M
Institut Municipal de la Salut, Ajuntament de Barcelona.
Gac Sanit. 1995 Jul-Aug;9(49):224-31. doi: 10.1016/s0213-9111(95)71241-9.
We present the evaluation of the population impact of a social and health maternal and child intervention, implemented in a low income urban area (Ciutat Vella) in Barcelona, Spain. Intervention was based on increasing access to health and social services for pregnant women and for the children. A quasiexperimental design with a nonequivalent control group and multiple measurements was used. We compared infant and perinatal cumulative mortality rates between Ciutat Vella District and the rest of the city, before (1983-86) and after the intervention (1987-89, 1990-92). Results showed that the significant differences found previously to the program between the mortality rates disappeared with the development of the program. Infant mortality in Ciutat Vella was 17.7/.000 births in 1983-86, and became 13.1/1.000 births in 1987-89, and 13.4 in 1990-92; in the rest of the city, infant mortality was 9.5/1.000 births in 1983-86, and became 8.8/ and 7.7/1000 births respectively. A comprehensive social and health care program implemented in small low income areas may contribute to reduce inequalities in maternal and child health.
我们展示了对一项社会与健康母婴干预措施人群影响的评估,该措施在西班牙巴塞罗那的一个低收入城区(旧城区)实施。干预措施基于增加孕妇和儿童获得健康及社会服务的机会。采用了带有非对等对照组和多次测量的准实验设计。我们比较了旧城区与该市其他地区在干预措施实施前(1983 - 1986年)以及实施后(1987 - 1989年、1990 - 1992年)的婴儿及围产期累积死亡率。结果显示,在该项目实施前发现的死亡率显著差异随着项目的开展而消失。旧城区的婴儿死亡率在1983 - 1986年为每1000例出生中有17.7例,在1987 - 1989年降至每1000例出生中有13.1例,在1990 - 1992年为13.4例;在该市其他地区,婴儿死亡率在1983 - 1986年为每1000例出生中有9.5例,在1987 - 1989年及1990 - 1992年分别降至每1000例出生中有8.8例和7.7例。在小型低收入地区实施的综合社会与医疗保健项目可能有助于减少母婴健康方面的不平等现象。