现有的干预措施能否终结母亲,新生儿和死产的可预防死亡,而且需要付出什么代价?
Zulfiqar A Bhutta1, Jai K Das2, Rajiv Bahl3
1Center for Global Child Health, Hospital for Sick Children, Toronto, Canada; Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Lancet (London, England)
|May 24, 2014
概括
改善新生儿生存率需要扩大有效护理规模. 基于设施的干预措施可以防止每年数百万的孕产妇,死胎和新生儿死亡,在节约生命方面具有显著的成本效益.
科学领域:
- 全球卫生健康 全球卫生健康
- 孕产妇和儿童的健康
- 新生儿死亡率 新生儿死亡率
背景情况:
- 在全球范围内,新生儿存活率和死胎减少的进展仍然缓慢.
- 到2035年实现每个新生儿的目标,需要加快有效干预措施的扩大.
- 新生儿死亡的主要原因需要有针对性的护理策略.
研究的目的:
- 系统地审查整个护理连续性的干预措施.
- 在高负担国家模拟扩大干预的效果和成本.
- 估计可能减少孕产妇,死胎和新生儿死亡的可能性.
主要方法:
- 对跨护理连续和提供平台的干预措施进行系统审查.
- 在75个高负担 Countdown国家模拟扩大干预措施的影响和成本.
- 基于设施的与基于社区的护理策略的分析.
主要成果:
- 到2020年,基于设施的护理可以预防113,000例孕产妇死亡,531,000例死产,以及每年1.325万例新生儿死亡,估计成本为45亿美元.
- 到2025年增加干预措施的覆盖范围和质量,每年可以避免71%的新生儿死亡,33%的死产和54%的孕产妇死亡.
- 基于设施的护理占了大部分效果 (82%) 和运行成本 (64%).
结论:
- 加快有效护理的扩大,特别是基于设施的干预措施,对于实现全球新生儿生存目标至关重要.
- 在分娩和分娩期间的干预对新生儿死亡有最大的影响,其次是照顾小和生病的新生儿.
- 可以实现与计划生育的协同效应,并有针对性地减少早产,产后和感染相关的死亡.
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