云南省怒江州儿童健康状况及影响因素分析

Analysis of children's health and influential factors in Nujiang prefecture,Yunnan

目的:了解云南省怒江州儿童健康现状及危害儿童健康的影响因素。方法:选取佝偻病患病率、生长迟缓率、低体重率作为关键指标计算所需7岁以下儿童样本量,使用四阶段抽样方法进行抽样。通过问卷调查、个人深入访谈和焦点组讨论等方法收集相关数据和信息,利用SAS9.2和Nvivo 8.0软件,并采用卡方检验和质性分析法对定量与定性资料进行分析。结果:2011年怒江州婴儿死亡率为13.14‰,分别是全国和云南省的1.1倍和1.15倍;5岁以下儿童死亡率为16.35‰,分别是全国和云南省的1.05倍和1.13倍,是世界发达国家的2.19倍;5岁以下儿童中、重度营养不良患病率为2.32%,是全国平均水平的1.54倍;低出生体重发生率为1.41%。而抽样调查显示,佝偻病、生长迟缓及低体重等营养性疾病患病率分别为36.13%、25.81%和20.98%,营养性疾病较为严重。结论:怒江州儿童健康问题较为严重,营养性疾病尤为突出,政策制度、经济发展水平、文化风俗习惯、地理条件、卫生服务能力、儿童家长/看护人知识文化水平等因素是较为重要的影响因素。建议:加强政策支持力度,发展地方经济,逐步改善影响儿童健康的社会和政策环境;加强机构、人员能力建设,提高服务的可及性和服务质量;普及健康教育知识,增强保健意识,改善健康行为。

Objective:To determine children ’ s health status and influential factors in Nujiang prefecture , Yun-nan.Methods:Rickets morbidity rate , growth retardation rate , and low-weight rate were selected as the key indica-tors to calculate the sample size by using four-stage-sampling procedure .The data was collected through questionnaire survey, in-depth interviews, and focus-group discussions .χ2 test and qualitative analysis were used to analyze the quantitative and qualitative data .Results:The infant mortality rate was 13.14 %in 2011, which was 1.1 and 1.15 times more than the national and provincial average .The mortality rate of children under five was 16.35%in 2011, which was 1.05 and 1.13 times more than the national and provincial average .It was also 2.19 times more than the average in developed countries .The prevalence of medium and severe malnutrition in children under five was 2 .32%, which was 1 .54 times more than the national average .The incidence of low birth weight was 1 .41%.The research shows that the rates of rickets , growth retardation , and low-weight were 36.13%, 25.81%and 20.98%,and nutritional diseases are more serious .Conclusion:There are serious health problems for children in Nujiang pre-fecture, especially nutritional diseases .Influential factors include health policy and system , economic development, customs, geography, health service capacity , and parental health knowledge Suggestion:The government should im-prove top-level design , strengthen policy support , and develop the local economy in order to solve the social and poli-cy environment factors .Institutions and human capacity should be strengthened , access and quality of services should be improved , health education should be popularized , and health awareness and behaviors should be improved .