Effect of Facilitation of Local Stakeholder Groups on Equity in Neonatal Survival; Results from the NeoKIP Trial in Northern Vietnam
Effect of Facilitation of Local Stakeholder Groups on Equity in Neonatal Survival; Results from the NeoKIP Trial in Northern Vietnam
复制标题
DOI：
10.1371/journal.pone.0145510
复制
发表时间：
2015-12-29
期刊：
影响因子：
3.7
通讯作者：
Selling, Katarina Ekholm
中科院分区：
文献类型：
--
作者：
Malqvist, Mats;Dinh Phuong Thi Hoa;Selling, Katarina Ekholm
背景要使后千年发展目标议程付诸实施，有必要评估卫生干预措施对公平的影响。这项研究的目的是评估NeoKIP试验(ISRCTN44599712)对新生儿存活的公平性的影响。该试验是一项以人群为基础的整群随机干预试验，在越南北部广宁省促进当地利益相关者群体改善新生儿存活。方法在研究期间(2008年7月至2011年6月)，对所有经历新生儿死亡的母亲和研究地区6%的活产母亲进行半结构化访谈。多水平回归分析，根据家庭财富、母亲教育程度和母亲种族对母亲进行分层，以评估对新生儿生存公平的影响。结果在最后一年的研究中，干预区贫困母亲的新生儿死亡风险比对照地区贫困母亲降低69%(OR 0.31，95%CI 0.15~0.66)。这种模式在来自非贫困家庭的母亲中并不明显。在同一时期内，受教育程度较高的母亲新生儿死亡风险降低50%(OR 0.50，95%可信区间0.28~0.90)，而受教育程度较低的母亲未发现明显影响。
BackgroundTo operationalize the post-MDG agenda, there is a need to evaluate the effects of health interventions on equity. The aim of this study is to evaluate the effect on equity in neonatal survival of the NeoKIP trial (ISRCTN44599712), a population-based, cluster-randomized intervention trial with facilitated local stakeholder groups for improved neonatal survival in Quang Ninh province in northern Vietnam.MethodsSemi-structured interviews were conducted with all mothers experiencing neonatal mortality and a random sample of 6% of all mothers with a live birth in the study area during the study period (July 2008-June 2011). Multilevel regression analyses were performed, stratifying mothers according to household wealth, maternal education and mother's ethnicity in order to assess impact on equity in neonatal survival.FindingsIn the last year of study the risk of neonatal death was reduced by 69% among poor mothers in the intervention area as compared to poor mothers in the control area (OR 0.31, 95% CI 0.15-0.66). This pattern was not evident among mothers from non-poor households. Mothers with higher education had a 50% lower risk of neonatal mortality if living in the intervention area during the same time period (OR 0.50, 95% CI 0.28-0.90), whereas no significant effect was detected among mothers with low education.InterpretationThe NeoKIP intervention promoted equity in neonatal survival based on wealth but increased inequity based on maternal education.