中低收入国家5岁以下儿童初级卫生保健服务干预措施有效性的回顾研究

A Systematic Review on the Effectiveness of Primary Health Care Interventions for Children under 5 Years Old in Low-and-middle-income Countries

目的:通过系统性回顾分析中低收入国家5岁以下儿童初级卫生保健服务干预措施的有效性,旨在为进一步提升中低收入国家儿童健康服务的有效性提供有效建议。方法:在Embase、PubMed、Cochrane图书馆和Web of Science 4个数据库中,按照参与者(5岁以下儿童)、干预措施、结果测量、国家和研究设计对检索词进行组织,检索发表时间为2000年1月—2021年6月的文献,同时,也对国际组织的资料和灰色文献进行了人工检索。结果:共纳入11篇符合标准的研究,均为评估促进中低收入国家5岁以下儿童初级卫生保健服务利用情况的干预研究。审查结果表明,综合社区个案管理和取消用户付费这两项干预措施在提高5岁以下儿童接受初级卫生保健服务和寻求护理方面表现出了积极作用。结论:建议进行更多的随机对照试验来评估所有的儿童健康干预措施,并对数据质量采取额外的预防措施。

OBJECTIVE To systematically review and analyze the effectiveness of primary health care service interventions for children under 5 years old in low-income countries,in order to provide effective suggestions for further improving the effectiveness of child health services in low-income countries.METHODS In EMBASE,PubMed,Cochrane Library and web of science,the search terms were organized according to the participants(children under 5 years old),intervention measures,result measurement,country and research design.The articles published from January 2000 to June 2021 were searched,and the data of international organizations and grey literature were also searched manually.RESULTS A total of 11 eligible studies were included,all of which were intervention studies to evaluate and promote the utilization of health care services for children under 5 years old in low-and middle-income countries.The results of the review showed that the two interventions of integrated community case management and the elimination of user fees have played a positive role in improving the access of children under the age of 5 to services and care.CONCLUSION It is suggested to conduct more randomized controlled trials to evaluate all child health interventions and take additional preventive measures for data quality.