影响5岁以下儿童死亡的多水平分析

Several levels analysis on the influence factors of death of the children under 5 years old

目的 :分析个体及社区因素对 5岁以下儿童死亡的影响 ,从而制定优先的降低 5岁以下儿童死亡的措施。方法 :采用在吉林、新疆、湖南、贵州、海南 114个县调查的 1997年的全部 5岁以下儿童死亡的县级加和资料以及相应的县级人口、经济、卫生资源等方面资料 ,采用多因素、多水平分析的方法研究影响我国部分贫困、偏远和少数民族地区 5岁以下儿童死亡的因素。结果 :采用多因素、多水平分析的方法发现 ,影响 5岁以下儿童死亡率的主要因素是产前检查率低 ,每千人口卫生人员少、每千人口儿科床位数少、人口密度低 ,人均收入低 ,以及儿科医生的技术水平 ,而个体因素对 5岁以下儿童死亡的影响较小。结论 :降低 5岁以下儿童死亡率应把重点放在人口稀疏地区和贫困人口 ,开展对贫困人口的医疗救助 ,加强孕产妇危险因素的筛查和管理 ,加强保健服务能力并提高群众利用保健服务的能力 ,健全妇幼卫生队伍 。

Objective: analyze the individual and community factors influenced on the death of children under 5 years old to set down the measure of reducing the death of children under 5 years old. Methods:make use of the addition data that death of children under 5 years old in 1997 which were investigated in 114 counties of Jilin, Xinjiang, Hunan, Guizhou, Hainan, the responsive county population, economy,health resource data,with the several factors, several levels analysis to study the death influence factors of the children under 5 years old in the Chinese partial poor, out of theway and minority districts.Results:the primary dealth influence factors included that the low antepartum examination,the few health personnel every 1 000 children, the few paediatric beds every 1 000 children, the low population density, the lower income per person and paediatrician's technology level. But the individual factor influenced less on the death of children under 5 years old. Conclusion: the important point of reducing the mortality of the children under 5 years old was sparse population district and the poor population, the medical treatment help on the poor population should be carried out. By strengthening the supervision of pregnant and lying in women's risk factors and health care service ability, raising the crowd's ability making use of health care service to perfect the maternity and children health rank and raise the paediatrician' service technique.