解释母婴健康的区域差异:印度和孟加拉国的其他确定因素
Susmita Dasgupta1, Subhendu Roy2, David Wheeler3
1The World Bank, 1818 H Street NW, Washington, DC 20433, USA.
Health policy OPEN
|June 29, 2023
概括
儿童消耗和孕产妇贫血的空间变化受到卫生服务,政治稳定,宗教文化和洪水易感的影响,而不仅仅是社会经济因素. 改进的区域政策可以提高母亲和儿童健康结果.
科学领域:
- 全球健康 全球健康
- 孕产妇和儿童的健康
- 健康的社会经济决定因素
背景情况:
- 儿童消耗和孕产妇贫血是关键的全球卫生问题,特别普遍存在于南亚.
- 现有的研究往往侧重于个人层面的社会经济因素,可能忽视了关键的区域决定因素.
- 健康结果的空间差异需要对地理上聚集的影响因素进行调查.
研究的目的:
- 确定印度和孟加拉国儿童消耗和母亲贫血的空间变异的关键驱动因素.
- 评估区域因素在传统社会经济和人口统计变量之外的重要性.
- 为改善母婴健康结果提供有针对性的政策干预信息.
主要方法:
- 使用了包含人口和健康调查变量 (母亲的教育,年龄,家庭财富) 的概率模型.
- 纳入区域固定效应以捕捉未观察到的空间异质性.
- 重新估计的模型用健康服务,政治不稳定,宗教文化和洪水易感等措施取代区域固定效应.
主要成果:
- 区域固定效应非常显著,表明传统因素无法解释的实质性空间变化.
- 卫生服务,政治稳定,宗教文化和洪水易发性都是儿童消耗和母亲贫血的重要预测因素.
- 同样的社会经济地位的群体在拥有更好的卫生服务,政治稳定和资源可用性的地区表现出更好的健康结果.
结论:
- 区域因素,如医疗服务提供,政治稳定,宗教文化和环境风险 (洪水易感) 是儿童衰竭和母亲贫血的关键决定因素.
- 针对这些区域因素的政策干预可以导致母亲和儿童健康的显著改善.
- 产后母亲的健康状况与长期儿童健康结果密切相关.
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