入手可能な介入により,母親,新生児,死産の予防可能な死亡を終わらせることができるのか?そして,その代償は?
Zulfiqar A Bhutta1, Jai K Das2, Rajiv Bahl3
1Center for Global Child Health, Hospital for Sick Children, Toronto, Canada; Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Lancet (London, England)
|May 24, 2014
まとめ
新生児の生存率を改善するには,効果的なケアを拡大する必要があります. 施設ベースの介入は,毎年数百万の母性,死産,新生児死亡を予防することができ,命を救うための費用対効果が顕著です.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 母親と子供の健康について
- 新生児死亡率 新生児死亡率
背景:
- 新生児の生存率と死産の減少における進歩は,世界的に依然として遅い.
- 2035年までにすべての新生児を対象とする目標を達成するには,効果的な介入の加速的な拡大が必要です.
- 新生児死亡の主な原因は,標的型ケア戦略を必要とします.
研究 の 目的:
- 介護の連続体全体にわたる介入を体系的にレビューする.
- 高負担国における介入拡大の効果とコストをモデル化するため.
- 妊産婦,死産児,新生児死亡率の潜在的減少を推定する.
主な方法:
- 介護継続と提供プラットフォームにおける介入の体系的なレビュー.
- 高負荷の75カ国の介入拡大の影響とコストをモデル化.
- 施設ベースの介護戦略とコミュニティベースの介護戦略の分析.
主要な成果:
- 施設ベースの介護は,毎年113,000人の妊産婦死亡,531,000人の死産,そして1,325万人の新生児死亡を2020年までに防ぐことができ,推定費用は45億ドルです.
- 2025年までに介入の範囲と質を拡大すれば,毎年新生児死亡の71%と死産の33%,母子の死亡の54%を回避できる.
- 施設での介護が最大の効果 (82%) と,運営費 (64%) を占めている.
結論:
- 効果的なケア,特に施設内での介入の加速拡大は,新生児生存率の世界の目標を達成するために極めて重要です.
- 産出と出産中の介入は,新生児死亡に最大の影響を及ぼし,次に小さな病気の新生児のケアが続きます.
- 家族計画と連携した効果と,早産,産内,感染症による死亡率の有意な削減は達成可能である.
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