贵州省平塘县2006～2014年5岁以下儿童死亡情况分析

An Analysis of the Under Five Mortality Rates(U5MR) during 2006-2014 in Guizhou Pingtang

目的分析平塘县5岁以下儿童死亡、死因和卫生服务利用情况。方法利用“三网”监测资料计算死亡率,分析死因、死亡地点和卫生服务利用构成比并作趋势比较。结果全县5岁以下儿童死亡率为44.2‰。2006～2014年,儿童死亡率降幅达73.8%,新医改以来,死亡率年下降速率超20%。远高于千年发展目标要求。肺炎、腹泻和新生儿死亡是主要死亡原因。8年间死亡儿童未利用卫生服务的比例由45.1%降到17.9%。因思想认识和经济困难未利用卫生服务的死亡儿童比例逐年下降。但因交通不便而未利用卫生服务的死亡儿童比例超过50%,12%的儿童死在去医疗机构的路上。结论平塘县儿童死亡状况取得巨大改善;死亡原因发生很大转变;卫生服务利用情况显著改善。贫困山区要进一步降低儿童死亡率,除加强卫生系统对儿童死亡检测外,仍需多部门的共同努力。

Objective To analyze the trends and causes of under-five mortality, and health service utilization in Pingtang. Methods To estimate mortality rates using the MCH surveillance data. To analyze trends in the proportion of deaths by causes, place of death and health service utilization. Results The U5MR was 44.2%0 in Pingtang, decreasing by 73.8% during 2006-2014. Since the new health reform, the annual rate of reduction has been more than 20%, far surpasses the requirement of the MDG4. Pneumonia, diarrhea, and neonatal conditions were the leading causes of deaths. The proportion of deceased children who did not utilize health care decreased from 45.1% to 17.9%. For those who did not access care, contributions due to knowledge and financial difficulties decreased substantially. Those due to traffic inconvenience accounted for more than 50% and 12% children died on the way to health facilities. Conclusions Pingtang performs greatly in improving child health. To further decrease child mortality, inter-sector collaborations are warranted besides health sector.