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目的了解边远贫困山区5岁以下儿童死亡变化趋势及主要原因,为制定儿童保健干预措施提供科学依据。方法利用临翔区妇幼卫生2001-2014年报资料,结合历年来主要干预措施对5岁以下儿童死亡情况进行生态学趋势分析。结果历年来的妇幼保健干预措施促使临翔区5岁以下儿童死亡率呈逐年下降趋势,2013年开始降至9.29‰(38/4 091)低于全省平均水平(11.07‰);婴儿死因顺位前3位依次为出生窒息32.57%(143/439)、肺炎31.21%(137/439)、早产低出生体重19.82%(87/439),而1~4岁儿童的主要死因为意外死亡与肺炎;死前就医率为64.96%(76/117),在就医途中死亡比例仅为7.69%(9/117)。结论围产期保健仍然是边远贫困山区妇幼保健工作中的薄弱环节,降低5岁以下儿童死亡率应做好孕期、围产期保健工作、普及科学育儿知识,提高产儿科服务质量。加强网底建设,预防出生窒息、肺炎、早产是今后工作的重点。
Objective To understand the trends and main causes of death among children under 5 years old in remote and impoverished mountainous areas and provide a scientific basis for formulating child health care interventions. Methods Based on the data of annual reports of MCH from 2001 to 2014 in Linxiang District and the main interventions over the years, the ecological trend of death of children under 5 years was analyzed. Results The maternal and child health interventions over the years led to the decreasing trend of the mortality rate of children under 5 years of age in Linxiang District from 9.29 ‰ (38/4 091) to the average of 11.07 ‰ in 2013 (2013) The top three were 32.57% (143/439) of birth asphyxia, 31.21% (137/439) of pneumonia and 19.82% (87/439) of low birth weight preterm birth, while the main cause of death was accidental death in children aged 1-4 Pneumonia. The pre-mortem rate was 64.96% (76/117), with only 7.69% (9/117) of deaths being reported. Conclusions Perinatal health care is still the weakest link in maternal and child health care in remote and impoverished mountainous areas. To reduce the mortality rate of children under 5 years of age, we should do a good job in pregnancy and perinatal health care, popularize scientific knowledge about child rearing, and improve the quality of pediatric services. Strengthening the construction of the network to prevent birth asphyxia, pneumonia, premature delivery is the focus of future work.