印度五岁以下儿童的生存率:一个参数式的多层次生存方法
Ajit Kumar Jaiswal1,2, Manoj Alagarajan3, Wahengbam Bigyananda Meitei4
1, Mumbai, India. ajitjaiswal20@gmail.com.
BMC public health
|April 9, 2024
概括
了解印度的五岁以下儿童死亡率需要检查个人和社区因素. 这项研究强调了环境特征对于降低儿童死亡率的重要性.
科学领域:
- 公共卫生 公共卫生
- 人口统计学 人口统计学
- 流行病学 流行病学
背景情况:
- 现有的印度五岁以下儿童死亡率研究主要集中在个人层面的因素上.
- 我们对社区层面因素对五岁以下儿童死亡率的影响的理解有限.
- 多层次分析对于评估个人和上下文特征的联合影响至关重要.
研究的目的:
- 调查个人和社区层面因素对印度五岁以下儿童死亡率的影响.
- 应用多层次分析以了解不同层次 (个人,地区,州) 五岁以下儿童死亡率的变化.
- 为旨在减少五岁以下儿童死亡率的政策干预提供基于证据的建议.
主要方法:
- 利用印度国家家庭和健康调查 (2015-16) 第四轮数据.
- 采用多层次参数生存模型 (MPSM) 来分析数据.
- 模拟的个体嵌入区,区嵌入州以捕捉层次效应.
主要成果:
- 五岁以下儿童的死亡率在分娩间隔不到两年的妇女和三等或以上的妇女中最高.
- 阶级内相关系数 (ICC) 值表明,在州 (1.17%) 和地区 (0.65%) 层面,社区层面的影响显著.
- 死亡风险在生命的第一年是最高的,逐渐增加到三岁,然后稳定.
结论:
- 个人和环境社区因素对于解释印度五岁以下儿童死亡率的变化至关重要.
- 政策举措必须超越个人层面的干预措施,并纳入环境特征,以有效减少五岁以下儿童死亡率.
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