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巴西的母亲和儿童健康:进展和挑战
Cesar G Victora1, Estela M L Aquino, Maria do Carmo Leal
1Post-Graduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. cvictora@gmail.com
Lancet (London, England)
|May 13, 2011
概括
在过去的30年里,巴西显著改善了儿童健康和营养,降低了婴儿死亡率和发育迟缓. 关键因素包括社会经济变化,公共卫生计划和国家卫生服务,尽管过度医疗化等挑战仍然存在.
科学领域:
- 公共卫生和卫生服务研究研究
- 孕产妇和儿童的健康
- 健康平等与健康的社会决定因素
背景情况:
- 在过去的三十年里,巴西在健康和卫生服务组织的社会决定因素方面经历了重大变化.
- 这些变化对母亲健康,儿童健康和儿童营养指标产生了重大影响.
- 了解这些影响对于基于证据的健康政策和干预至关重要.
研究的目的:
- 检查社会经济和卫生系统变化对巴西母亲和儿童健康指标的影响.
- 分析婴儿死亡率,儿童发育迟缓和获得卫生干预措施的趋势.
- 确定导致巴西进步的因素以及在母婴健康方面存在的挑战.
主要方法:
- 利用了来自重要统计,人口普查,人口统计和健康调查以及公布的报告的数据.
- 分析了婴儿死亡率,新生儿死亡率和5岁以下儿童缩患病率的趋势.
- 评估了获得母婴健康干预措施和母乳养时间的变化.
主要成果:
- 婴儿死亡率大幅降低 (在20世纪80年代/90年代每年5.5%,自2000年以来4.4%) 和发育迟缓的流行率 (从37%降至7%).
- 显著增加对母亲和儿童健康干预措施的获取,接近全民覆盖,减少不平等.
- 官方数据显示,孕产妇死亡率保持稳定,但建模数据显示,每年死亡率下降4%,可能是由于报告改善而掩盖的.
结论:
- 巴西通过社会经济变革,有针对性的卫生计划和国家卫生服务,在儿童健康和营养方面取得了重大改善.
- 进展归因于经济增长,收入差距减少,教育改善,通过家庭健康计划扩大医疗覆盖范围,以及跨部门行动.
- 持续存在的挑战包括过度医疗化分娩,非法堕胎导致的孕产妇死亡,以及高比例的早产.
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