Persistent neonatal mortality despite improved under-five survival:: a retrospective cohort study in northern Vietnam
Persistent neonatal mortality despite improved under-five survival:: a retrospective cohort study in northern Vietnam
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DOI：
10.1111/j.1651-2227.2007.00604.x
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发表时间：
2008-02-01
期刊：
影响因子：
3.8
通讯作者：
Persson, Lars Ake
中科院分区：
文献类型：
--
作者：
Hoa, Dinh P.;Nga, Nguyen T.;Persson, Lars Ake
目的：为了研究新生儿，婴儿和5岁以下的死亡率在越南北方地区在1970-2000年的趋势，并分析随着时间的推移，在儿童存活率的社会经济差异。方法：回顾性访谈与所有妇女年龄在15-54岁的巴维区在越南北方（n = 14 329）进行。1970- 2000年，有13943名妇女怀孕，分娩26796名儿童。结果：1970- 2000年，婴儿和5岁以下儿童死亡率显著下降（47%）。然而，新生儿死亡率的下降幅度很小，因此，新生儿死亡率在儿童总死亡率中所占的比例有所上升。死亡率趋势遵循越南在战争、和平和改革时期的政治和社会经济发展。五岁以下和新生儿死亡率与家庭经济没有差异，而与母亲的教育和种族的差异正在增加。结论：干预措施，以降低儿童死亡率应集中在改善新生儿护理。在越南等经济快速增长和随之而来的社会变革的背景下，重要的是，这种干预措施要针对弱势群体，在这种情况下，是教育水平低和属于少数民族的家庭。
Aim: To examine trends in neonatal, infant and under-five mortality rates in a northern Vietnamese district during 1970-2000, and to analyze socioeconomic differences in child survival over time.Methods: Retrospective interviews with all women aged 15-54 years in Bavi district in Northern Vietnam (n = 14 329) were conducted. Of these women, 13 943 had been pregnant, giving birth to 26 796 children during 1970-2000.Results: There was a dramatic reduction in infant and under-five mortality rate (47%) over time. However, the neonatal mortality rate (NMR) showed a very small reduction, thus causing its proportion of the total child mortality to increase. Mortality trends followed the political and socioeconomic development of Vietnam over war, peace and periods of reforms. There were no differences in under-five and neonatal mortalities associated with family economy, while differentials related to mothers' education and ethnicity were increasing.Conclusion: Interventions to reduce child mortality should be focused on improving neonatal care. In settings with a rapid economic growth and consequent social change, like in Vietnam, it is important that such interventions are targeted at vulnerable groups, in this case, families with low level of education and belonging to ethnic minorities.