緊急事態後期キャンプで避難した人々の死亡率の低下に関連した健康プログラムと政策:遡及的研究
Paul Spiegel1, Mani Sheik, Carol Gotway-Crawford
1International Emergency and Refugee Health Branch, Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. spiegel@unhcr.ch
Lancet (London, England)
|December 21, 2002
まとめ
難民キャンプでは,根拠に基づいた健康プログラムが不可欠です. キャンプの年齢,紛争の近く,水と医療へのアクセスなどの重要な要因は,避難した人々の死亡率に大きく影響を与えます.
科学分野:
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
- ヒューマニタリー・スタディズ 人道学研究
背景:
- 複雑な人道的緊急事態により,何百万人もの人々が避難を余儀なくされ,難民のための効果的な保健・栄養プログラムが必要となる.
- 緊急事態後のキャンプにおける現在の政策やプログラムは,しばしばデータに基づいた基盤が欠けている.
- 移住した人々の死亡率に関連した特定の健康指標を特定する必要性があります.
研究 の 目的:
- 緊急事態後の難民キャンプにおける年齢別死亡率と健康指標の関連性を特定する.
- 人道的な組織のための政策とプログラム開発を情報提供するために.
主な方法:
- 7カ国の51の緊急事態後のキャンプの死亡率データを遡及的に分析した (1998-2000).
- 多変数回帰分析は,粗末死亡率 (CMRs) と5歳未満の死亡率 (<5 MRs) に影響する18の独立変数を含む.
- 既定の緊急段階の最低指標との調査結果の比較.
主要な成果:
- 新設のキャンプは,古いキャンプと比較して,より高いCMRと<5MRを示した.
- 紛争地域への近接と病院への移動時間の長さは,CMRの増加と相関していた.
- 限られた水へのアクセスと高い下痢率は,より高い<5 MRsと関連していました.
- 紛争までの距離,水資源の供給,地元の保健医療従事者の密度などの重要な指標は,緊急段階の勧告を上回りました.
結論:
- 難民の健康と栄養への介入は,根拠に基づいたものでなければならない.
- 複雑な緊急事態におけるプログラムは,死亡率に関連する指標を優先すべきである.
- 緊急事態後のキャンププログラムのための特定の最低限の指標の開発が推奨されています.
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