发展中国家的卫生工作者和疫苗接种范围:经济学分析
Sudhir Anand1, Till Bärnighausen2
1University of Oxford, Department of Economics, Oxford, UK; Harvard University, Global Equity Initiative, Cambridge, MA, USA.
Lancet (London, England)
|April 17, 2007
概括
更高的护士密度显著提高了发展中国家的儿童疫苗接种覆盖率,表明卫生工作者对于疫苗接种至关重要. 国家收入没有影响免疫率.
科学领域:
- 全球健康 全球健康
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 疫苗可预防的疾病导致发展中国家每年超过100万名儿童死亡.
- 卫生方面的人力资源对于疫苗接种至关重要,但它们对人口水平的影响还未得到充分研究.
研究的目的:
- 调查发展中国家卫生工作者密度与儿童疫苗接种覆盖率之间的联系.
主要方法:
- 进行了跨国多重回归分析.
- 依赖变量包括麻疹含有疫苗 (MCV) 覆盖率,白喉疹咳 (DTP3) 和脊髓灰质炎 (脊髓灰质炎3).
- 独立变量是总体卫生工作者密度,分别是医生和护士密度,控制收入,识字率和土地面积.
主要成果:
- 总体卫生工作者密度与所有三种疫苗的覆盖率正相关.
- 护士密度与MCV,DTP3和脊髓灰质炎的覆盖率有显著的积极关联.
- 医生密度与任何疫苗接种覆盖率都没有显著关联;更高的女性成年人识字率和更小的土地面积也与覆盖率增加有关.
结论:
- 增加护士的密度提高了接种疫苗服务的可用性,提高了儿童免疫率.
- 国家收入不是免疫覆盖率的决定因素.
- 卫生工作者,特别是护士的可用性是影响发展中国家疫苗接种范围的关键因素.
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