Neonatal mortality in the empowered action group states of India: Trends and determinants
Neonatal mortality in the empowered action group states of India: Trends and determinants
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DOI：
10.1017/s0021932007002623
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发表时间：
2008-03-01
影响因子：
1.5
通讯作者：
Gautam, Abhishek
中科院分区：
文献类型：
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作者：
Arokiasamy, Perianayagam;Gautam, Abhishek
在印度，八个社会经济落后的邦，比哈尔邦、恰蒂斯加尔邦、恰尔肯德邦、中央邦、奥里萨邦、拉贾斯坦邦、北方邦和北方邦，被称为赋权行动小组(EAG)，在人口转型方面落后，婴儿死亡率是全国最高的。新生儿死亡率约占印度婴儿总死亡率的60%，在EAG邦最高。这项研究评估了EAG地区新生儿死亡率的水平和趋势，并比较了生物人口学和卫生保健决定因素对新生儿死亡率的影响。使用的数据来自印度的样本登记系统(SRS)和国家家庭与健康调查(NFHS-2,1998-99)。COX比例风险模型被应用于通过医疗保健、生物人口统计学和社会经济决定因素来估计调整后的新生儿死亡率。这些决定因素导致的新生儿死亡率差异表明，全面覆盖所有孕妇，在分娩时提供援助和包括紧急护理在内的产后护理，是实现降低新生儿死亡率的关键投入。还需要采取卫生干预措施，重点减少母亲分娩时年龄较小、儿童出生体重低和出生间隔较短的高位分娩所造成的新生儿死亡的高风险。
In India, the eight socioeconomically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh, referred to as the Empowered Action Group (EAG) states, lag behind in the demographic transition and have the highest infant mortality rates in the country. Neonatal mortality constitutes about 60% of the total infant mortality in India and is highest in the EAG states. This study assesses the levels and trends in neonatal mortality in the EAG states and examines the impact of bio-demographic compared with health care determinants on neonatal mortality. Data from India's Sample Registration System (SRS) and National Family and Health Survey (NFHS-2, 1998-99) are used. Cox proportional hazard models are applied to estimate adjusted neonatal mortality rates by health care, bio-demographic and socioeconomic determinants. Variations in neonatal mortality by these determinants suggest that universal coverage of all pregnant women with full antenatal care, providing assistance at delivery and postnatal care including emergency care are critical inputs for achieving a reduction in neonatal mortality. Health interventions are also required that focus on curtailing the high risk of neonatal deaths arising from the mothers' younger age at childbirth, low birth weight of children and higher order births with short birth intervals.