Satyanarayana L, Indrayan A, Sachdev H P, Gupta S M
Division of Biostatistics and Epidemiology, Institute of Cytology and Preventive Oncology, Maulana Azad Medical College Campus, New Delhi.
Indian Pediatr. 1995 Apr;32(4):443-52.
The aim of this study was to develop a single comprehensive index of child mortality for longitudinal assessment of health status of children. The need for such a comprehensive index arose from conflicting trends in different child mortality indicators. The data for the study was taken from the Sample Registration System (SRS) reports of the Registrar General of India. SRS is known to provide reliable estimates of births and deaths at the State and the National level. The study included five child mortality indicators, namely, under five mortality rate (U5MR), infant mortality rate, neonatal mortality rate, perinatal mortality rate and still birth rate. These were available for fifteen states of India over the years 1972-1988. To develop this index we modified an earlier method based on factor analysis. Factor analysis of data on various indicators of child mortality revealed two factors which together explained 78% to 93% of the total variation in different years. The first factor was identified as representing mortality after birth and the second as before and during birth. The comprehensive index was obtained as a linear combination of these two factors. The resultant index thus fairly represented all five mortality indicators and provided a comprehensive and reasonably correct picture of child mortality. The lower the magnitude of this index, the better was the child health status. Trends in the index showed that the highest decline in the magnitude was in the state of Kerala followed by Punjab, Andhra Pradesh, Gujarat and Maharashtra in that order. This indicates steady improvement of the child health status over years in these states. In the State of Jammu and Kashmir, the index remained more or less constant over the years though the magnitude was low in the cross-sectional comparison with other states. Thus the comprehensive index developed by using factor analysis of the various mortality indicators can be used for the longitudinal monitoring of child health status in the states of India.
本研究的目的是制定一个单一的儿童死亡率综合指数，用于纵向评估儿童的健康状况。制定这样一个综合指数的需求源于不同儿童死亡率指标呈现出的相互矛盾的趋势。本研究的数据取自印度注册总署的样本登记系统（SRS）报告。众所周知，SRS能提供邦和国家层面可靠的出生和死亡估计数据。该研究纳入了五个儿童死亡率指标，即五岁以下儿童死亡率（U5MR）、婴儿死亡率、新生儿死亡率、围产期死亡率和死产率。这些数据涵盖了1972年至1988年期间印度的15个邦。为了制定这个指数，我们对基于因子分析的早期方法进行了修改。对各种儿童死亡率指标数据的因子分析揭示了两个因子，这两个因子共同解释了不同年份总变异的78%至93%。第一个因子被确定为代表出生后的死亡率，第二个因子代表出生前和出生期间的死亡率。综合指数是这两个因子的线性组合。由此得出的指数相当全面地反映了所有五个死亡率指标，提供了儿童死亡率的全面且较为准确的情况。该指数的数值越低，儿童的健康状况就越好。指数趋势表明，数值下降幅度最大的是喀拉拉邦，其次依次是旁遮普邦、安得拉邦、古吉拉特邦和马哈拉施特拉邦。这表明这些邦多年来儿童健康状况在稳步改善。在查谟和克什米尔邦，该指数多年来基本保持不变，尽管在与其他邦的横向比较中数值较低。因此，通过对各种死亡率指标进行因子分析得出的综合指数可用于对印度各邦儿童健康状况进行纵向监测。
