Sanctions and childhood mortality in Iraq
Sanctions and childhood mortality in Iraq
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DOI：
10.1016/s0140-6736(00)02289-3
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发表时间：
2000-05-27
期刊：
影响因子：
168.9
通讯作者：
Shah, IH
中科院分区：
文献类型：
--
作者：
Ali, HM;Shah, IH
背景
1999年，联合国儿童基金会与伊拉克政府以及“自治”（库尔德北部）地区的地方当局合作，开展了类似的调查，以提供具有地区代表性且可靠的儿童死亡率（本文主题）和孕产妇死亡率的估算值。
方法
1999年2月和3月在伊拉克中南部进行的一项横断面家庭调查中，对居住在抽样家庭中的23105名15 - 49岁的已婚妇女，由经过培训的调查员使用一份依据人口与健康调查问卷制定并经过预测试的结构化问卷进行了访谈。在4月和5月对自治区进行的一项类似调查中，对14035名15 - 49岁的已婚妇女进行了访谈。
调查结果
在中南部，在调查前的10年期间，婴儿和5岁以下儿童死亡率有所上升，这大致与海湾冲突以及联合国制裁开始后的时期相对应。婴儿死亡率从1984 - 1989年期间的每1000例活产47例上升到1994 - 1999年的每1000例活产108例，5岁以下儿童死亡率从每1000例活产56例上升到131例。在同一时期的自治区，婴儿死亡率从每1000例活产64例下降到59例，5岁以下儿童死亡率从每1000例活产80例下降到72例。农村地区出生的儿童、母亲未受过教育的儿童以及男孩的儿童死亡率较高，并且这两个地区的这些差异大致相似。
解读
在海湾冲突以及伊拉克中南部处于联合国制裁之下后，儿童死亡率明显上升，但在自治区，自石油换食品计划启动以来，儿童死亡率已开始下降。向自治区更好地分配食物和资源有助于死亡率持续降低，然而尽管中南部地区识字率较高，但该地区的情况却恶化了。
Background In 1999 UNICEF, in cooperation government of Iraq and the local authorities In "autonomous" (northern Kurdish) region, conducted similar surveys to provide regionally representative and reliable estimates of child mortality (the subject of this paper) and maternal mortality.Methods In a cross-sectional household survey in the south/centre of Iraq in February and March, 1999, 23 105 ever-married women aged 15-49 years living in sampled households were interviewed by trained interviewers with a structured questionnaire that was developed using the Demographic and Health Surveys questionnaire and following a pre-test. In a similar survey in the autonomous region in April and May 14 035 ever-married women age 15-49 were interviewed.Findings In the south/centre, infant and under-5 mortality increased during the 10 years before the survey, which roughly corresponds to the period following the Gulf conflict and the start of the United Nations sanctions. Infant mortality rose from 47 per 1000 live births during 1984-89 to 108 per 1000 in 1994-99, and under-5 mortality rose from 56 to 131 per 1000 live births. In the autonomous region during the same period, infant mortality declined from 64 to 59 per 1000 and under-5 mortality fell from 80 to 72 per 1000. Childhood mortality was higher among children born in rural areas, children born to women with no education, and in boys, and these differentials were broadly similar in the two regions.Interpretation Childhood mortality clearly increased after the Gulf conflict and under UN sanctions in the south/centre of Iraq, but in the autonomous region since the start of the Oil-for-Food Programme childhood mortality has begun to decline. Better food and resource allocation to the autonomous region contributed to the continued gains in lower mortality, whereas the situation in the south/centre deteriorated despite the high level of literacy in that region.