1996～2006年城市和农村地区孕产妇死亡公平性分析

The inequality status of maternal mortality in China from 1996 to 2006

目的:利用全国妇幼卫生监测数据库,比较1996～2006年城乡之间、东中西部地区之间的孕产妇死亡率及公平性变化情况。方法:分别计算1996～1998年、1999～2001年、2002～2004年和2005～2006年城市和农村地区、东中西部地区的孕产妇死亡率,并计算率差、率比、人群归因危险度百分比、集中指数和绘制集中曲线图,比较4个时间段城乡之间、东中西部地区之间的孕产妇死亡公平性变化。结果:孕产妇总死亡率由1996～1998年的91.8/10万下降到2005～2006年的28.1/10万。农村地区的孕产妇死亡率高于城市,西部地区高于中部,中部高于东部。农村和城市地区的孕产妇率差为13.1/10万～44.6/10万,率比为1.2～2.7,人群归因危险度百分比为10.7%～51.3%;西部与东部的率差为54.5/10万～150.1/10万,率比为4.2～4.8;中部与东部的率差为24.4/10万～48.9/10万,率比2.1～3.0;人群归因危险度百分比为51.4%～61.1%。无论是城乡比较还是东中西部比较,4个时间段的集中指数均为负值,且变化不大;集中曲线均位于平等线之上。结论:1996～2006年,城市和农村之间、东中西部地区之间的孕产妇死亡存在不公平,且未见改善。

Objective： To compare the difference of maternal mortality ratios and to assess the maternal mortality inequality between urban and rural areas as well as between east, middle, and west China during 1996 - 2006. Methods： The data collected in National Maternal and Child Health Care Surveillance System, MMR, Rates difference （RD）, Rates ratio （RR）, population etiologic fraction （PAR%） as well as Concentration Index were calculated for 1996 - 1998, 1999 - 2001, 2002 - 2004, and 2005 - 2006. Concentration curve was drawn to assess the maternal mortality equality. Results： The MMR in rural areas was high than in urban areas, west higher than in middle, middle higher than in east despite that the MMR decreased from 91.8 per 100 000 live births in 1996 - 1998 to 28. 1 per 100 000 live births in 2005 -2006. RD between rural and urban areas varied from 13.1 per 100 000 to 44. 6 per 100 000 live births, RR varied from 1.2 - 2. 7, PAR% varied from 10. 7% to 51.3%. RD between west and east China varied from 54. 5 per 100 000 to 150. 1 per 100 000, RR varied from 4. 2 - 4. 8. RD between middle and east China varied from 24. 4 per 100 000 to 48.9 per 100 000 live births, RR varied from 2. 1 to 3.0. PAR% varied from 51.4% to 61.1%. The concentration indexes were all negative, and all concentration curves was above the diagonal. Conclusion： The inequality in maternal mortality existes during 1996 - 2006 and has not been improved.