论文部分内容阅读
目的评价WHO 194个会员国5岁以下儿童死亡率(U5MR)千年发展目标完成情况,分析全球U5MR现状。方法以《世界卫生统计2015》U5MR、主要死因构成比为基础,采用1990~2013年U5MR下降幅度评估千年发展目标完成情况,通过2000年与2013年阶段性比较分析U5MR变化规律,采用双变量Pearson相关分析判断U5MR与“感染非感染性疾病比值”、人均GDP的相关性。结果截至2013年,在194个WHO会员国中,46个(23.71%)国家U5MR实现了千年发展目标。2000年与2013年比较,六大洲、低和高死亡率组U5MR差异有统计学意义(P<0.05),中等死亡率组差异无统计学意义(P>0.05);中、低死亡率组“感染非感染性疾病比值”差异无统计学意义(P>0.05),高死亡率组差异有统计学意义(P<0.05)。低与中、中与高死亡率组U5MR、“感染非感染性疾病比值”及平均下降量比较差异有统计学意义(P<0.05)。全球U5MR地区性差异明显,非洲U5MR均值最高,欧洲最小,大洋洲、南美洲、北美洲居中,亚洲渐趋中等水平。各国U5MR与“感染非感染性疾病比值”呈高度正相关关系(r2000年=0.934,r2013年=0.911,P<0.05),与人均GDP呈低度负相关关系(r2000年=–0.443,r2013年=–0.433,P<0.05)。结论降低全球U5MR任重而道远,防控重点应放在非洲和亚洲。防控感染性疾病是中、高死亡率国家的有效措施之一,防控非感染性疾病是低死亡率国家的重要措施之一。加大卫生投入是进一步降低全球U5MR的重要途径。
Objective To assess the achievement of the Millennium Development Goals (MDGs) for mortality in children under 5 years of age in the 194 WHO Member States and to analyze the status of the global U5MR. Methods Based on World Health Statistics 2015 U5MR and the composition ratio of the major causes of death, the achievement of the MDGs was evaluated from the declining rate of U5MR from 1990 to 2013. The changes of U5MR were compared by phases from 2000 to 2013, and the bivariate Pearson Correlation analysis to determine the correlation between U5MR and “Infectious Disease Infectious Diseases Ratio”, per capita GDP. Results As of 2013, out of 194 WHO Member States, 46 (23.71%) of national U5MRs met the Millennium Development Goals. Compared with 2013, the difference of U5MR in six continents with low and high mortality rate was statistically significant (P <0.05), while there was no significant difference in medium mortality rate (P> 0.05) between 2000 and 2013. Middle and low mortality group There was no significant difference in the “Infectious Diseases Infectious Diseases Ratio” (P> 0.05), and there was a significant difference between the high mortality groups (P <0.05). The difference of U5MR, “ratio of noninfectious disease” and average decrease between low and middle, middle and high mortality group was statistically significant (P <0.05). The global U5MR regional differences significantly, the highest average value of Africa U5MR, the youngest in Europe, Oceania, South America, North America center, Asia has become more moderate. There was a high positive correlation between U5MR and “Infectious Diseases Infectious Diseases” (r 2000 = 0.934, r = 0.911, r = 0.911, P <0.05) and low negative correlation with GDP per capita (r 2000 = -0.443, r 2013 = -0.433, P <0.05). Conclusion To reduce the global long-term U5MR long-term, prevention and control should focus on Africa and Asia. Prevention and control of infectious diseases is one of the effective measures in countries with medium and high mortality rates. Prevention and control of non-infectious diseases is one of the important measures in low-mortality countries. Increase health investment is an important way to further reduce the global U5MR.