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利用卫—Ⅵ项目地区报告的1997年5岁以下儿童死亡资料,重点围绕死亡水平、死亡儿童年龄构成、死因构成及死亡地点加以分析,并对新生儿死亡率与部分服务利用指标进行了多元回归分析。结果显示,项目地区1997年报告的5岁以下儿童死亡率平均为52.0‰,各省较基线调查时均有不同程度下降,但仍远高于全国农村平均水平。5岁以下儿童死亡中,婴儿死亡占77.3％,婴儿死亡中,新生儿死亡占66.9％;儿童死于家中的构成比居第一位,死于乡卫生院居第二位。感染性疾病(肺炎和腹泻)以及与孕产期保健及产科质量密切相关的死因(新生儿窒息和早产或低出生体重)是婴儿死亡的主要原因,一半以上的1～4岁儿童死亡是由于肺炎和腹泻引起。多元回归分析显示,新生儿死亡率仅与住院分娩率有统计学关联,而与产前检查、新法接生、产后访视无统计学关联。结果提示:项目地区儿童死亡仍有很大降低的余地,在项目开展过程中,应进一步提高产前检查及产后访视的质量,促进住院分娩,增强村民识别儿童危险指征的能力与就医意识,同时加强医疗机构,特别是乡卫生院救治儿童疾病尤其是肺炎、腹泻的能力。
Based on the data on the deaths of children under 5 years of age reported in Wei-Ⅵ project area in 1997, the author focuses on the level of death, the age composition of the deceased children, the cause of death and the place of death, and conducts multiple regression on the neonatal mortality rate and some service utilization indicators analysis. The results showed that the average mortality rate of children under 5 years of age reported in 1997 in the project area was 52.0 ‰, with all provinces dropping to some extent from the baseline survey but still far above the national average of rural areas. Among the deaths of children under 5 years of age, 77.3% were infant deaths and 66.9% were neonatal deaths. Children died at home in the first place and died in township hospitals. Infectious diseases (pneumonia and diarrhea) and causes of death (neonatal asphyxia and premature birth or low birth weight) that are closely related to maternal health and obstetrical quality are the major causes of infant mortality and more than half of all deaths of children aged 1 to 4 are due to Pneumonia and diarrhea cause. Multivariate regression analysis showed that neonatal mortality was only associated with hospital delivery rate was statistically associated with prenatal care, new birth attendance, postpartum visits were not statistically significant. The results suggest that there is still much room for reduction of child deaths in the project area. During the project development, the quality of prenatal and postnatal visits should be further improved, hospital delivery should be promoted, and villagers’ ability to recognize children’s dangerous indications be enhanced. , While strengthening the capacity of medical institutions, especially township hospitals, to treat childhood diseases, especially pneumonia and diarrhea.