Maternal Health and Survival in Pakistan: Issues and Options
Maternal Health and Survival in Pakistan: Issues and Options
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DOI：
10.1016/s1701-2163(16)34321-3
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发表时间：
2009-10-01
影响因子：
1.8
通讯作者：
Bhutta, Zulfiqar A.
中科院分区：
文献类型：
--
作者：
Khan, Yasir P.;Bhutta, Shereen Z.;Bhutta, Zulfiqar A.
虽然孕产妇死亡率可能难以衡量，但它是全球孕产妇健康的一个关键指标。在巴基斯坦，每年有500多万妇女怀孕，其中70万人（占所有孕妇的15%）可能会遇到一些产科和医疗并发症。据估计，每年有30 000名妇女死于与怀孕有关的原因，最近的估计表明，孕产妇死亡率为每年每100 000名新生儿中有276人死亡。在这次审查中，我们描述了巴基斯坦孕产妇健康和生存状况，并将其置于更广泛的关键决定因素的背景下。我们提请注意孕妇在经济和社会方面的脆弱性，并强调必须同时采取更广泛的战略，包括减贫和增强妇女权能。女孩营养不良、早婚和高生育率，加上避孕需求得不到满足，是巴基斯坦孕产妇健康不良的重要决定因素。我们的审查还研究了影响巴基斯坦妇女孕产妇保健服务利用不足的因素，如缺乏熟练的护理人员和质量差的服务。尽管有这些意见，但已有循证干预措施，如果大规模实施，可为减轻巴基斯坦孕产妇死亡率负担作出重要贡献。
Although its measurement may be difficult, the maternal mortality ratio (MMR) is a key indicator of maternal health globally. In Pakistan each year over five million women become pregnant, and of these 700 000 (15% of all pregnant women) are likely to experience some obstetrical and medical complications. An estimated 30 000 women die each year from pregnancy-related causes, and the most recent estimates indicate that the MMR is 276 per 100 000 births annually. In this review, we describe the status of maternal health and survival in Pakistan and place it in its wider context of key determinants. We draw attention to the economic and social vulnerability of pregnant women, and stress the importance of concomitant broader strategies, including poverty reduction and women's empowerment. Undernutrition for girls, early marriage, and high fertility rates coupled with unmet needs for contraception are important determinants of maternal ill health in Pakistan. Our review also examines factors influencing the under-utilization of maternal health services among Pakistani women, such as the lack of availability of skilled care providers and poor quality services. Notwithstanding these observations, there are evidence-based interventions available that, if implemented at scale, could make important contributions towards reducing the burden of maternal mortality in Pakistan.