中国2000-2010年5岁以下儿童死亡率和死亡原因分析

Under-5-mortality rate and causes of death in China, 2000 to 2010

目的评估2000--2010年中国5岁以下儿童死亡率（U5MR）及主要死因别死亡率的变化，评价实现《中国儿童发展纲要（2001--2010年）》（纲要）目标的进展。方法采用全国5岁以下儿童死亡监测网收集的2000--2010年以人群为基础的监测资料，计算不同地区的婴儿死亡率（IMR）、U5MR及其主要死因别死亡率。结果2010年全国IMR和U5MR较2000年分别下降59．3％和58．7％，城市IMR和U5MR分别下降50．8％和47．1％，农村IMR和U5MR分别下降56．5％和56．0％。与2000年相比，2010年全国5岁以下儿童主要疾病的死因别死亡率均有下降，但城乡下降程度不同。位于前五位的死因是早产或低出生体重、肺炎、出生窒息、先天性心脏病和意外窒息，城乡儿童主要疾病顺位不完全相同。2010年农村IMR和U5MR均是城市的2．8倍，中、西部地区的IMR分别是东部的1．5倍和2．3倍，U5MR分别是东部的1．5倍和2．2倍。结论2000--2010年全国IMR、U5MR及主要死因别死亡率有明显下降趋势，且实现了纲要中提出的目标，但缩小地区和人群差异是今后促进儿童健康面临的重大挑战。

Objective To assess the changes and the leading cause of deaths for children under 5 years old, in China, during 2000-2010, with the aim of evaluation on the progress in achieving the relative goal set by ＂National Program of Action for Child Development in China （2001-2010） ＂, and understanding the related challenges. Methods Data used in this study were collected from the population-based National Maternal and Child＇ s Health Surveillance Network of China. Infant Mortality Rate （IMR）, Under-5-mortality rate （U5MR） and the leading cause of deaths for under-5 children were analyzed. Results Nationwide IMR and U5MR in 2010 dropped by 59.3% and 58.7% respectively, compared to that in 2000. Decreases by 50.8% and 47.1% in IMR and U5MR were observed in urban areas, and 56.5% and 56.0% in rural areas during this period. Compared with data from 2000, the leading causes-specific U5MR in 2010 had significantly declined. The top 5 leading causes of death in 2010 were premature birth/low birth weight, pneumonia, birth asphyxia, congenital heart disease and accidental suffocation, but were different in urban and rural areas. In 2010, both IMR and U5MR from the rural areas were 2.8-folds than that of the urban areas. In addition, IMRs in the Middle and Western parts of China were 1.5 and 2.3-folds respectively of that in the East, and U5MR in Middle and West was 1.5 and 2.2-folds respectively of that in East. Conclusion IMR, U5MR and the leading causes specific mortality rate in China declined remarkably from 2000 to 2010, and the goal set by ＂National Program of Action for Child Development in China （2001-2010）＂ had been successfully achieved. However, the disparity on child＇ s health in regions and in urban or rural areas, still remained a challenge.