与在紧急后期营地流离失所者的死亡率降低相关的卫生计划和政策:一项回顾性研究
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
概括
在难民营中,以证据为基础的卫生计划至关重要. 关键因素,如营地的年龄,接近冲突,以及获得水和医疗保健,显著影响流离失所人口的死亡率.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 人道主义研究 人道主义研究
背景情况:
- 复杂的人道主义紧急情况使数百万人流离失所,需要为难民提供有效的健康和营养计划.
- 紧急情况后营地的当前政策和计划往往缺乏数据驱动的基础.
- 需要确定与流离失所人口死亡率相关的特定健康指标.
研究的目的:
- 在紧急情况后的难民营中确定特定年龄的死亡率和健康指标之间的关联.
- 为人道主义组织制定政策和方案提供信息.
主要方法:
- 七个国家的51个紧急情况后营地死亡率数据的回顾性分析 (1998年至2000年).
- 多变量回归分析包含18个独立变量,影响原始死亡率 (CMRs) 和五岁以下死亡率 (<5MRs).
- 结果与已建立的紧急阶段最低指标进行比较.
主要成果:
- 与较旧的营地相比,新成立的营地表现出较高的CMR和<5MR.
- 靠近冲突地区和更长的前往医院的旅行时间与增加的CMR相关.
- 有限的饮用水和高的腹率与更高的<5MRs相关.
- 关键指标,如冲突距离,水资源供应和当地卫生工作者密度,超过了紧急阶段的建议.
结论:
- 对流离失所者的健康和营养干预措施必须基于证据.
- 复杂紧急情况的方案应优先考虑与死亡率相关的指标.
- 建议为紧急情况后营地计划制定具体的最低指标.
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