关于母婴死亡率的千年发展目标4和5的进展:更新的系统分析
Rafael Lozano1, Haidong Wang, Kyle J Foreman
1Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA. rlozano@u.washington.edu
Lancet (London, England)
|September 23, 2011
概括
儿童和产妇死亡率正在下降,但大多数国家到2015年将无法实现千年发展目标 (MDGs) 4和5. 加速行动对于实现这些全球卫生目标至关重要.
科学领域:
- 全球健康 全球健康
- 人口统计学 人口统计学
- 公共卫生 公共卫生
背景情况:
- 监测实现千年发展目标 (MDGs) 4和5的进展至关重要,2015年是关键目标年.
- 之前对母婴死亡率的估计是在2010年发表的;由于新的数据和方法,需要更新数据.
- 该研究旨在提供最准确的证据来跟踪MDG 4和5的进展.
研究的目的:
- 通过使用最新的可用数据和可靠的方法,更新对母婴死亡率的估计.
- 评估实现千年发展目标4 (儿童死亡率) 和5 (孕产妇死亡率) 的进展情况.
主要方法:
- 更新的分析包括了额外的调查,人口普查,生命记录和口头尸检数据.
- 儿童死亡率估计用于早期新生儿,晚期新生儿,新生儿后,儿童 (1-4岁) 和5岁以下的年龄组,使用改进的模型.
- 孕产妇死亡率分析包括超过1000个额外的地点年数据,使用集成模型估计从1990年到2011年.
主要成果:
- 2011年,5岁以下的死亡人数下降至720万,新生儿和儿童死亡率显著降低.
- 106个国家在2000年至2011年间与前十年相比,加速了儿童死亡率的下降.
- 产妇死亡人数从1990年的409,100人减少到2011年的273,500人;其中56,100人与艾滋病毒有关.
- 预测显示,31个国家将实现MDG4,13个国家将实现MDG5,9个国家将实现两者.
结论:
- 虽然许多国家在减少母婴死亡率方面的进展正在加速,但大多数发展中国家将超过2015年的千年发展目标目标.
- 降低孕产妇死亡率的步伐仍然缓慢,缺乏整体加速.
- 许多国家需要立即采取协调一致的全球行动,才能实现千年发展目标4和千年发展目标5.
相关概念视频
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:28International Nursing Organizations II
The World Health Organization (WHO) is a specialized agency of the United Nations based in Geneva. The WHO has many initiatives that center around health. Primarily, they lead global efforts to expand universal health coverage using science-based policies and programs. They are also responsible for shaping health research agendas and developing norms and standards.
The WHO provides expert team support, including funding, vaccines, testing, and treatment tools at the country level to fight...
The WHO provides expert team support, including funding, vaccines, testing, and treatment tools at the country level to fight...
01:52Regression Toward the Mean
Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when researchers try to extrapolate results...
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
00:57Population Growth
Population size is dynamic, increasing with birth rates and immigration, and decreasing with death rates and emigration. In ideal conditions with unlimited resources, populations can increase exponentially, which plots as a J-shaped growth rate curve of population size against time. This type of curve is characteristic of newly-introduced invasive species, or populations that have suffered catastrophic declines and are rebounding.
01:29Malaria
Malaria pathogenesis in humans reflects a delicate interplay between parasite biology and host response. Clinical illness reflects a host’s immune response to the parasite’s asexual replication cycle, which is often asymptomatic in individuals with partial immunity. From the parasite's perspective, transmission between mosquito and human with minimal host pathology is evolutionarily advantageous. Among the six Plasmodium species infecting humans, P. falciparum and P. vivax dominate in global...