Unreported births and deaths, a severe obstacle for improved neonatal survival in low-income countries; a population based study.
Unreported births and deaths, a severe obstacle for improved neonatal survival in low-income countries; a population based study.
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DOI：
10.1186/1472-698x-8-4
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发表时间：
2008-03-28
影响因子：
3
通讯作者：
Persson, Lars-Ake
中科院分区：
文献类型：
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作者：
Malqvist, Mats;Eriksson, Leif;Persson, Lars-Ake
背景：为了提高儿童存活率，有必要以新生儿死亡率为目标。在这方面，有效的地方和国家儿童健康统计数据至关重要。我们分析了低收入国家未报告出生和新生儿死亡的程度，并讨论了在地方和国际层面为拯救新生儿生命所做的努力的后果。方法：通过对关键线人的小组访谈、问卷调查和检查卫生设施记录，通过系统清查确定了2005年越南北部广宁省所有出生和新生儿死亡的信息。187个社区卫生中心（CHC）和18家医院的卫生保健人员以及1372名村卫生工作者（VHW）被纳入研究。结果与省卫生局的官方报告进行了比较。结果：新生儿死亡率（NMR）为16/1000（284例新生儿死亡/17,519例出生），而官方死亡率为4.2/1000。该省不同地区的核磁共振值在44/1000和10/1000之间变化。报告不足的主要原因是报告制度不健全，以及由家庭而不是卫生系统负责登记出生和死亡。这种低报现象在地方、国家和国际各级造成严重后果。在局部层面上，它导致缺乏对核磁共振的大小和差异的认识，导致对问题漠不关心。在国家和国际一级，人们认为的低死亡率表现为缺乏对围产期保健方案的投资。结论：据报道，这一卫生信息系统缺陷的例子在新生儿卫生改革需求最大的低收入和中等收入国家并不罕见。改进出生和新生儿死亡报告制度是一项人权问题，也是降低新生儿死亡率以实现第四个千年目标的先决条件。
BACKGROUND: In order to improve child survival there is a need to target neonatal mortality. In this pursuit, valid local and national statistics on child health are essential. We analyze to what extent births and neonatal deaths are unreported in a low-income country and discuss the consequences at local and international levels for efforts to save newborn lives.METHODS: Information on all births and neonatal deaths in Quang Ninh province in Northern Vietnam in 2005 was ascertained by systematic inventory through group interviews with key informants, questionnaires and examination of health facility records. Health care staff at 187 Community Health Centers (CHC) and 18 hospitals, in addition to 1372 Village Health Workers (VHW), were included in the study. Results were compared with the official reports of the Provincial Health Bureau.RESULTS: The neonatal mortality rate (NMR) was 16/1000 (284 neonatal deaths/17,519 births), as compared to the official rate of 4.2/1000. The NMR varied between 44/1000 and 10/1000 in the different districts of the province. The under-reporting was mainly attributable to a dysfunctional reporting system and the fact that families, not the health system, were made responsible to register births and deaths. This under-reporting has severe consequences at local, national and international levels. At a local level, it results in a lack of awareness of the magnitude and differentials in NMR, leading to an indifference towards the problem. At a national and international level the perceived low mortality rate is manifested in a lack of investments in perinatal health programs.CONCLUSION: This example of a faulty health information system is reportedly not unique in low and middle income countries where needs for neonatal health reforms are greatest. Improving reporting systems on births and neonatal deaths is a matter of human rights and a prerequisite for reducing neonatal mortality in order to reach the fourth millennium goal.