中国部分贫困地区5岁以下儿童死亡情况分析

Analysis on Under-five Child Deaths in Part of Poor Rural Areas of China

利用卫—Ⅵ项目地区报告的1997年5岁以下儿童死亡资料,重点围绕死亡水平、死亡儿童年龄构成、死因构成及死亡地点加以分析,并对新生儿死亡率与部分服务利用指标进行了多元回归分析。结果显示,项目地区1997年报告的5岁以下儿童死亡率平均为52.0‰,各省较基线调查时均有不同程度下降,但仍远高于全国农村平均水平。5岁以下儿童死亡中,婴儿死亡占77.3％,婴儿死亡中,新生儿死亡占66.9％;儿童死于家中的构成比居第一位,死于乡卫生院居第二位。感染性疾病(肺炎和腹泻)以及与孕产期保健及产科质量密切相关的死因(新生儿窒息和早产或低出生体重)是婴儿死亡的主要原因,一半以上的1～4岁儿童死亡是由于肺炎和腹泻引起。多元回归分析显示,新生儿死亡率仅与住院分娩率有统计学关联,而与产前检查、新法接生、产后访视无统计学关联。结果提示:项目地区儿童死亡仍有很大降低的余地,在项目开展过程中,应进一步提高产前检查及产后访视的质量,促进住院分娩,增强村民识别儿童危险指征的能力与就医意识,同时加强医疗机构,特别是乡卫生院救治儿童疾病尤其是肺炎、腹泻的能力。

Basing on data of reported under - five child deaths from ' Comprehensive Maternal and Child Health Project' areas in China, which was funded by World Bank, the paper focused on under - five mortality rate,child deaths by age,child deaths by cause and by site. Also the paper did multiple regression analysis on neonatal mortality rate and some indivators of service utilization. The results showed that the under -five child mortality rate on average in 1997 in the project areas was 52. 0 per 1000 living births which was much lower than the level in 1992 and 1993, but was still higher than the average level of the whole rural China. Infant deaths occupied 77. 3% of under - five child deaths. Neonatal deaths consisted of 66. 9% of infant deaths. Infectious diseases, such as pneumonia and diarrhea were identified as primary factors occupying 42. 4% of infant deaths and 52, 7% of 1 - 4 child deaths in 1997. The proportion of children dying at home was 56. 0% for infants and 36. 7 for neonatal in 1997. Multiple regression analysis showed that neonatal mortality rate had only statistical relationship with the factors of prenatal care of postpartum visit of sterilized delivery. The results suggested that there was still big potential to reduce under - five mortality further in the project areas. The strategies should include: improving the quality of prenatal cares and postpartum visitsjencouraging delivery in hospital;through education,enhancing the ability of villagers for detecting danger signs of children and seeing doctors in an appropriate hospital; improving the ability of doctors, especially township doctors,for treatment of pneumeonia and diarrhea diseases.