Retrospective comparative evaluation of the lasting impact of a community-based primary health care programme on under-5 mortality in villages around Jamkhed, India.
Retrospective comparative evaluation of the lasting impact of a community-based primary health care programme on under-5 mortality in villages around Jamkhed, India.
复制标题
对印度贾姆赫德周边村庄基于社区的初级卫生保健计划对 5 岁以下儿童死亡率的持久影响进行回顾性比较评估。
DOI：
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发表时间：
2010
影响因子：
11.1
通讯作者：
Peter D Boone
中科院分区：
文献类型：
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作者：
Vera Mann;A. Eble;Chris Frost;R. Premkumar;Peter D Boone
目标
对综合农村卫生项目对马哈拉施特拉邦农村地区儿童死亡率的长期影响进行首次严格评估。
方法
通过进行家庭调查和采访妇女来收集背景信息和完整的出生史。人口规模与项目村相似的控制村是从以项目区为中心（但不包括项目区）的两个椭圆围成的区域中随机选择的。从这两个地区随机抽取了相同数量的村庄以及大致相同数量的家庭和妇女。使用具有稳健标准误的 Cox 模型来比较项目村和对照村 5 岁以下儿童的死亡风险。
研究结果
在对受试者的种姓和宗教以及村庄的灌溉情况进行调整后，与对照村相比，项目村新生儿期后的死亡风险降低了 30%（95% 置信区间，CI：6% 至 48%）。新生儿期死亡风险增加3%，但无统计学意义（95% CI：-18%至29%）。
结论
我们的方法为评估长期运行的基于社区的初级卫生保健计划提供了有用的工具。我们的研究结果加剧了关于旨在降低儿童死亡率的社区干预措施的长期可持续性的日益激烈的争论。
OBJECTIVE
To conduct the first rigorous evaluation of the long-term effect of the Comprehensive Rural Health Project on childhood mortality in rural Maharashtra.
METHODS
Background information and full birth histories were collected by conducting household surveys and interviewing women. Control villages resembling project villages in terms of population size were randomly selected from an area enclosed by two ellipses centred around, but not including, the project area. An equal number of villages and approximately equal numbers of households and women were randomly sampled from both areas. Cox models with robust standard errors were used to compare the hazard of death among children under 5 years of age in project and control villages.
FINDINGS
The hazard of death was reduced by 30% (95% confidence interval, CI: 6% to 48%) after the neonatal period in the project villages compared with control villages after adjustment for caste and religion of subjects and for availability of irrigation in the villages. During the neonatal period there was an increase of 3% in the hazard of death, but it was not statistically significant (95% CI: -18% to 29%).
CONCLUSION
Our methods provide useful tools for evaluating long-running community-based primary health care programmes. Our findings add to the growing debate on the long-term sustainability of community-based interventions designed to reduce child mortality.