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【目的】了解当前贵州农村地区儿童健康干预现状,遴选出有效干预并提出现阶段儿童保健的优先干预,为相关决策提供循证信息。【方法】收集整理机构统计及入户调查数据,采用the Lives Saved Tool(LiST)软件,以2008年作为基线年,对2008-2015年与5岁以下儿童死亡率下降有直接和间接关系的妇幼干预效果进行测算和拟合。【结果】有效降低新生儿死亡率的干预依次为:母乳喂养、住院分娩和治疗性干预;有效降低1～59个月儿童死亡人数的干预依次为:母乳喂养、预防性措施、疫苗接种和治疗性措施。【结论】1)有效的儿童健康干预集中在改善环境及卫生习惯、加强乡级医疗机构分娩医疗质量、推广口服补液盐(ORS)治疗及补Zn常规处理;扩大肺炎球菌疫苗、轮状病毒疫苗和流感嗜血杆菌疫苗的接种率将大幅度降低儿童死亡数;2)根据LiST模拟出的重点干预项目有侧重点地加强基层现有妇幼卫生保健,有利于明确未来地区妇幼卫生资源的分配方向,为后续研究提供借鉴。
【Objective】 To understand the status quo of children’s health intervention in rural areas of Guizhou Province, select effective interventions and propose priority interventions for child health at this stage, and provide evidence-based information for relevant decisions. 【Method】 Collect the statistics of organization and household survey data. Using the Lives Saved Tool (LiST) software, take 2008 as the baseline year, and have a direct and indirect relationship between the 2008-2015 women and children The effect of intervention is estimated and fitted. [Results] The effective interventions for reducing neonatal mortality were as follows: breastfeeding, hospital delivery and therapeutic intervention; interventions to effectively reduce the number of deaths in children aged 1-59 months were: breastfeeding, prophylactic measures, vaccination and treatment Sexual measures. 【Conclusion】 1) Effective intervention for children’s health focused on improving the environment and hygiene habits, strengthening the medical quality of childbirth at village-level medical institutions, promoting the oral rehydration salts (ORS) treatment and routine zinc supplementation; expanding the pneumococcal vaccine and rotavirus vaccine And Haemophilus influenzae vaccines will significantly reduce the number of child deaths; 2) According to the key intervention projects simulated by LiST, the emphasis on strengthening the existing MCH at the grass-roots level will help clarify the distribution direction of MCH resources in the future , Provide reference for follow-up research.