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予防的介入の共同カバーと子供の生存戦略への影響:国家調査からの証拠
Cesar G Victora1, Bridget Fenn, Jennifer Bryce
1Universidade Federal de Pelotas, CP 464, 96001-970 Pelotas, RS, Brazil. cvictora@terra.com.br
Lancet (London, England)
|October 26, 2005
まとめ
子どもの生存のための介入は不均等に分布しており,貧しい子どもたちは,多くの場合,より少ないサービスを提供されている. このような小児保健の介入のクラスタリングは,特に新しいプログラムが導入されると,不平等を悪化させる可能性があります.
科学分野:
- 世界的な子どもの健康
- 健康の公平性に関する研究
- 公共衛生の介入分析 公共衛生の介入分析
背景:
- 低所得国では,児童生存のための複数の介入が実施されています.
- 子どもの個別レベルでのこれらの介入のクラスタリングの評価は,カバーのギャップを理解するために重要です.
研究 の 目的:
- 9つの低所得国における児童生存介入の共同カバーを分析する.
- 介入分配における社会経済的不平等を調査する.
主な方法:
- 9カ国 (バングラデシュ,ベニン,ブラジル,カンボジア,エリトリア,ハイチ,マラウィ,ネパール,ニカラグア) のデータを分析した.
- 各子どもが受けた介入に基づいて,共同カバーのスコアを計算した.
- 主要成分分析と集中指標を用いて社会経済的地位を評価した.
主要な成果:
- 各国の介入範囲とクラスタリングの有意な変動が観察されました.
- 介入を受けていない子どもの割合は0.3%から18.8%でした.
- 大規模な社会経済的不平等が認められ,最も貧しいクインティルは,特に低覆盖率の国では,より少ない介入を受けています.
結論:
- 介入のクラスタリングは不平等を悪化させ,すでにカバーされている子供たちにより多くの利益をもたらす可能性があります.
- 複数の介入のための単一の配信戦略は,全体的な人口のカバーが高くない場合,不平等を増加させる可能性があります.
- 共同カバー分析は,介入の公平性を評価するための貴重なツールです.
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