難民や流出した人. 戦争,飢餓,そして公衆衛生
1Centers for Disease Control and Prevention, Atlanta, Ga 30333.
JAMA
|August 4, 1993
まとめ
難民や国内避難民,特に子どもたちの死亡率が高く,世界規模で難民が急増しています. 予防可能な病気と栄養不良は,死亡率の主要な原因であり,国際的な介入と救済プログラムの改善が必要である.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 人道的危機 人道的危機
- デモグラフィー デモグラフィー 人口統計
背景:
- 世界規模での移住の拡大: 戦争や内戦によって引き起こされた4300万人以上の難民と国内避難民 (IDPs) が支援を必要としています.
- 継続的に高い死亡率: 移住者集団の総死亡率 (CDR) は,原住民の出身国における基線比率と比較して,依然として著しく上昇しています.
- 脆弱なグループが不均衡に影響を受ける: 5歳未満の子供,そして場合によっては女性も,かなり高い死亡率を経験する.
研究 の 目的:
- 難民と国内避難民の現在の死亡率 (CDR) を分析する.
- 移住者集団における死亡率とリスク要因の主要な原因を特定する.
- 既存の救援プログラムの有効性を評価し,改善を推奨する.
主な方法:
- 移転人口と非移転人口における粗死率 (CDR) の比較分析.
- 1990年以来,世界中の様々な難民と国内避難民の状況から得られた死亡率データをレビューする.
- 感染症や栄養不良を含む死亡の主な原因の特定.
主要な成果:
- いくつかの受け入れ国における難民のCDRは基値の5~12倍,イラク,ソマリア,スーダンにおける国内避難民のCDRは12~25倍である.
- 死亡率は,5歳未満の子どもでは著しく高い.
- 下痢性疾患,麻疹,呼吸器感染症などの予防可能な疾患は,栄養失調によって悪化し,死亡の主な原因となっています.
結論:
- 難民支援の改善にも関わらず,国内避難民の状況は悪化している可能性がある.
- 移住を伴う複雑な人道的緊急事態において,早期の国際的介入が不可欠である.
- 援助プログラムは,特に脆弱な集団の住居,食料,水,衛生,疾病予防に重点を置いた,根拠に基づいた健康と栄養戦略を優先しなければなりません.
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