产妇死亡率,死胎和新生儿死亡率:基于对151个国家的分析的过渡模型
Ties Boerma1, Oona M R Campbell2, Agbessi Amouzou3
1Institute for Global Public Health and Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
The Lancet. Global health
|June 22, 2023
概括
一个新的五阶段模型追踪了减少孕产妇,死胎和新生儿死亡的进展. 大多数国家已经进入了先进的阶段,在医疗保健获取和结果方面有所改善,有助于全球卫生战略.
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:
- 孕产妇死亡率,死胎和新生儿死亡率每年导致近500万人死亡.
- 这些结果通常被单独分析,尽管有共同的原因和干预措施.
- 为了更好的分析和战略规划,需要采用统一的方法.
研究的目的:
- 开发和验证一个全面的五阶段死亡率过渡模型.
- 分析不同国家的孕产妇,死胎和新生儿死亡率的变化.
- 确定与降低这些死亡率进展相关的因素.
主要方法:
- 利用联合国对151个国家的估计来评估2000年至2020年的死亡率变化.
- 根据死亡率定义了五个过渡阶段.
- 检查了有关死亡原因,生育率,卫生政策,劳动力,融资,社会经济指标和服务覆盖面的特定阶段数据.
主要成果:
- 2000年在第一到第四阶段的116个国家中,73%的国家在2020年至少取得了一阶段的进展.
- 进展与传染病/产后并发症死亡人数下降,生育率下降,医疗工作人员改善,医疗支出增加和自付费用减少相关.
- 在各阶段观察到产前护理,机构分娩和剖腹产率的显著增加,在机构分娩覆盖范围中减少了与财富相关的不平等.
结论:
- 五阶段模型为评估国家和次国家在减少孕产妇,死胎和新生儿死亡率方面的进展提供了一个基准.
- 它有助于确定进步驱动因素,并为可持续发展目标的战略规划提供信息.
- 促进综合战略,以结束可预防的孕产妇和新生儿死亡率和死产.
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