获得医疗保健的问题和5岁以下的死亡率:对50个低收入和中等收入国家的综合分析
Jinseo Kim1, Yun-Jung Eom1, Soohyeon Ko1
1Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea.
Journal of public health (Oxford, England)
|April 29, 2024
概括
在低收入和中等收入国家,获得医疗保健 (PAHC) 的问题与较高的五岁以下死亡率 (U5M) 有关. 社会文化障碍是导致儿童死亡率的最重要因素.
科学领域:
- 全球健康 全球健康
- 儿科死亡率 儿科死亡率
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在低收入和中等收入国家 (LMICs) 中,低于最佳的医疗保健准入显著影响着幼儿生存率.
- 难以获得医疗保健 (PAHC) 是LMICs儿童生存的关键障碍.
研究的目的:
- 系统地评估获得医疗保健 (PAHC) 和五岁以下儿童死亡率 (U5M) 之间的关系.
- 确定PAHC的特定领域,这些领域对U5M贡献最大.
主要方法:
- 利用了50个LMIC (2013-2021) 人口和健康调查的数据,涵盖724,335例活产.
- 将PAHC分为经济,物理和社会文化领域.
- 使用多变量逻辑回归来分析PAHC和U5M之间的关系.
主要成果:
- 综合的五岁以下儿童死亡率为每1000个活产的47.3.
- 超过一半 (57.1%) 的参与者报告了PAHC,区域差异很大.
- 任何PAHC都与U5M的几率增加有关 (OR:1.05,95%CI:1.02,1.09),特别是在撒哈拉以南非洲.
- 获得护理的社会文化障碍与U5M的关联最为显著.
结论:
- 改善LMICs的医疗保健准入对于降低五岁以下儿童死亡率至关重要.
- 战略应侧重于扩大医疗保健覆盖范围,增强物理基础设施,并解决特定背景的社会文化障碍.
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