非洲撒哈拉以南地区死胎社区干预措施的影响:系统审查和元分析
Uchenna Gwacham-Anisiobi1, Yebeen Ysabelle Boo1, Adetola Oladimeji2
1National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
基于社区的干预措施本身并不能显著减少撒哈拉以南非洲的死产. 将社区的努力与卫生设施的改善相结合,是降低死产率的关键.
科学领域:
- 公共卫生 公共卫生
- 全球健康 全球健康
- 孕产妇健康 孕产妇健康
背景情况:
- 撒哈拉以南非洲 (SSA) 面临着高死亡出生负担,2019年全球贡献42%.
- 尽管增加了基于社区的干预措施,但SSA的死产率的减少速度一直很慢.
- 这些社区干预措施在SSA的有效性仍未得到充分评估.
研究的目的:
- 系统地审查和分析基于社区的干预措施对撒哈拉以南非洲死产率的影响.
- 评估独立社区干预与社区和卫生设施综合干预方法的有效性.
主要方法:
- 一个系统的审查和对来自15个SSA国家的17项研究的元分析 (2000-2023).
- 搜索了多个数据库和灰色文献,包括MEDLINE,Embase和Cochrane.
- 包括针对死胎的社区干预措施;不包括仅限于医院的干预措施和特定计划.
主要成果:
- 仅在社区进行的干预措施没有显著降低死产概率 (OR 0.96;95% CI 0.78-1.17).
- 结合社区和卫生设施的干预措施,显著降低了17%的死胎几率 (OR 0.83;95% CI 0.79-0.87).
- 研究质量各不相同,6项被评为良好,9项被评为公平,2项被评为不良.
结论:
- 仅仅基于社区的干预措施是不足以大幅减少SSA的死产.
- 将社区干预与加强卫生设施能力相结合,对于减少死产至关重要.
- 未来的战略应侧重于协同方法,以便对孕产妇和新生儿健康结果产生更大的影响.
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