環境と栄養の介入を通じて子供の生存率を改善する:貧困層への介入をターゲットにすることの重要性
Emmanuela Gakidou1, Shefali Oza, Cecilia Vidal Fuertes
1Initiative for Global Health, Harvard University, Cambridge, Massachusetts, USA.
JAMA
|October 24, 2007
まとめ
環境と栄養に関する介入の実施は,特に貧困層を優先する場合,幼児死亡率を大幅に低減します. これらの取り組みは,世界の幼児死亡率削減目標を達成するのに大きく貢献しています.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 環境衛生 環境衛生 環境衛生
- 公衆衛生は公衆衛生である.
背景:
- 国連のミレニアム開発目標 (MDGs) は,貧困,健康,持続可能性に取り組んでいます.
- MDGの介入の間の相互作用は十分に研究されていない.
- これらの相互作用を理解することは,資源の配分に極めて重要です.
研究 の 目的:
- 環境と栄養に関するMDGの介入による子供の死亡率の減少を推定する.
- 介入効果が受益者の経済的地位によってどのように変化するかを評価する.
主な方法:
- 集団レベルの比較リスク評価モデリング.
- 人口統計調査と健康調査を用いた経済的地位による階層化された分析.
- WHOの幼児死亡率データと流行病学的メタ解析を用いた.
主要な成果:
- ユニバーサルな介入によって,毎年490万 (ラテンアメリカ/カリブ海),810万 (南アジア),147万 (サハラ以南のアフリカ) の5歳未満の子どもを救える.
- 貧困層を優先する50%のカバーは,より裕福なグループを優先するよりも,より大きな死亡率の減少をもたらします.
- 利益は,MDGの目標である児童死亡率における地域格差の30%~48%を占めています.
結論:
- 栄養と環境に関するMDGの介入は,小児死亡率削減の目標を大幅に前進させる.
- 貧困層への介入を優先することで,小児死亡率の減少を最大限に抑えることができます.
- 統合された介入戦略は,世界保健目標を達成するための鍵です.
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