Success factors for reducing maternal and child mortality
Success factors for reducing maternal and child mortality
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DOI：
10.2471/blt.14.138131
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发表时间：
2014-07-01
影响因子：
11.1
通讯作者：
Bustreo, Flavia
中科院分区：
文献类型：
--
作者：
Kuruvilla, Shyama;Schweitzer, Julian;Bustreo, Flavia
降低孕产妇和儿童死亡率是千年发展目标中的一个优先事项，2015年后可能仍将如此。有证据表明需要投资、干预和扶持政策。对于为什么有些国家比其他可比国家取得更快的进展，人们知之甚少。《妇女和儿童健康的成功因素》研究试图利用以下方法弥补这一知识差距：对144个中低收入国家20年来的数据进行统计和计量经济学分析;布尔定性比较分析;文献审查;以及对10个快速通道国家千年发展目标4和5 a的国别审查。快速通道国家没有标准的公式，只能采用量身定制的战略，并迅速适应变化。然而，快速通道国家在降低孕产妇和儿童死亡率的三个主要领域采取了一些共同的有效办法。首先，这些国家让多个部门参与解决关键的健康决定因素。自1990年以来，中低收入国家儿童死亡率的下降约有一半是卫生部门投资的结果，另一半是卫生部门以外部门投资的结果。其次，这些国家利用战略动员全社会的合作伙伴，利用及时、有力的证据进行决策和问责，并采用三重规划办法来考虑眼前的需求、长期愿景和适应变化。第三，各国制定指导原则，确定进展方向，协调利益攸关方的行动，并随着时间的推移取得成果。这一证据综合有助于全球了解到2015年之前及之后如何加快改善妇女和儿童健康。
Reducing maternal and child mortality is a priority in the Millennium Development Goals (MDGs), and will likely remain so after 2015. Evidence exists on the investments, interventions and enabling policies required. Less is understood about why some countries achieve faster progress than other comparable countries. The Success Factors for Women's and Children's Health studies sought to address this knowledge gap using statistical and econometric analyses of data from 144 low-and middle-income countries (LMICs) over 20 years; Boolean, qualitative comparative analysis; a literature review; and country-specific reviews in 10 fast-track countries for MDGs 4 and 5a. There is no standard formula fast-track countries deploy tailored strategies and adapt quickly to change. However, fast-track countries share some effective approaches in addressing three main areas to reduce maternal and child mortality. First, these countries engage multiple sectors to address crucial health determinants. Around half the reduction in child mortality in LMICs since 1990 is the result of health sector investments, the other half is attributed to investments made in sectors outside health. Second, these countries use strategies to mobilize partners across society, using timely, robust evidence for decision-making and accountability and a triple planning approach to consider immediate needs, long-term vision and adaptation to change. Third, the countries establish guiding principles that orient progress, align stakeholder action and achieve results over time. This evidence synthesis contributes to global learning on accelerating improvements in women's and children's health towards 2015 and beyond.