卫生Ⅷ项目对婴儿死亡的影响评价
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摘要
研究目标
总体目标为评价卫生Ⅷ项目对于项目地区婴儿死亡的影响,具体目标为评估和确定项目县常规统计报告中的婴儿死亡率(IMR)数据的准确性;系统分析各类项目县婴儿死亡率的变化情况,包括分析比较不同贷款来源、不同干预措施的项目县的婴儿死亡特征(死亡年龄,死亡原因,性别、死亡地点等)的差异及整个项目期间的时间变化趋势;分析项目干预措施以及当地社会、经济等因素对项目地区婴儿死亡率的影响。
资料和方法
1.资料来源:本次研究所用资料主要有项目县逐年上报监督评价资料,现场调查漏报调查资料和本次评价期间收集的项目县婴儿死亡报告卡和人口学资料。
2.分析方法:一般性统计描述方法为主分析项目县婴儿死亡率变化及婴儿死亡特征变化,利用多水平重复测量模型分析婴儿死亡率的影响因素。
研究结果
1.项目地区的平均漏报率由前半阶段的27.8%降至项目后半段的25.4%,仅有轻微的下降趋势。
2.全部项目县的漏报校正后的婴儿死亡率在项目期间大幅下降,与全国农村地区婴儿死亡率的平均水平的差距逐渐缩小,至项目末期项目地区仅比全国农村地区高2.4‰。
3.新生儿死亡在全部婴儿死亡中比例提高,DFID试点县和MCH干预县提高的幅度要大于一般项目县。
4.在项目期间,项目地区死亡婴儿中男性的比例一直大于女性。男、女婴儿死亡率在整个项目期间基本相同,且在项目期间均有快速下降,由项目前期男、女婴儿的死亡率均在39‰左右降至项目末期的21‰以下。
5.死于医院的婴儿的比例不断上升。分性别来看,男性婴儿和女性婴儿死于医院的比例均在上升,且男性死亡婴儿中死于医院中的比例相对女性增加得更快。
6.项目地区婴儿死亡前曾经就诊于门诊和医院的比例在项目期间不断上升。按干预类型看,DFID试点县和MCH干预县未就医的比例在下降,而一般项目县未就医的比例小幅上升。
7.项目地区在项目早期有五分之一的婴儿死亡前未进行诊断,而在项目末期,有73%的婴儿在死亡前曾到过乡级或乡级以上的医院进行诊治。一般项目县中死前未进行诊断的比例下降幅度慢于其它两个类型的项目县。
8.项目地区通过临床诊断确诊婴儿死亡原因的比例不断增加。DFID试点县和MCH干预县通过临床诊断确定死因的比例的增幅要高于一般项目县。
9.项目地区感染性疾病的死因顺位和死亡率均为下降趋势:先天异常类死因的比例和死亡率呈上升趋势;新生儿窒息在项目末期成为项目地区婴儿死亡的第一位死因;诊断不明类的疾病在项目期间均排在第4位。
10.项目地区婴儿死亡率的影响因素为年份,孕产妇系统管理率,年内四苗接种率和项目地区粗出生率,而干预类型、农民人均纯收入等变量与婴儿死亡率没有统计学上的意义。
结论
1.项目地区的平均婴儿死亡率和全国农村的婴儿死亡率的平均水平的差距是在逐渐缩小的,说明卫生Ⅷ项目的实施可以提高项目地区的婴儿健康水平,项目的实施对于婴儿死亡率的下降是有明显效果的。
2.项目地区新生儿死亡的比例上升,婴儿死前的卫生服务利用水平提高,感染性疾病对于项目地区婴儿的死亡威胁在降低,项目地区婴儿死亡的特征向发达国家转变,MCH干预县和DFID试点县的死亡模式转变的速度和程度要优于一般项目县。
3.婴儿死亡率的影响因素分析表明,项目地区的婴儿死亡率的下降主要是因为提高了项目地区的孕产期的妇幼保健服务利用水平,同时在项目地区人均收入水平对于婴儿死亡率的影响并不显著。
Objective
The overall objective is to evaluate the impact of healthⅧproject on infant death. The specific objective are to analyze the trend of infant mortality rate in overall project counties,to compare the difference of infant death and times trend among the three type project counties,and explore the influencing factors of infant mortality rate.
Materials and Methods
1.Source of materials:In this study,we mainly use the three sources of data,which are monitoring data of project counties,underreporting data by household survey and collected infant death certificates and demographic data of project counties.
2.Methods:Descriptive statistical methods were used to analyze the trend of infant mortality rate and characteristics of infant death in project counties.Besides,in this study,we applied the multi-level model to explore the influencing factors of infant mortality rate of project counties.
Results
1.Underreporting rate of infant death dropped a little during the period of project, from 27.8%in the early stage to 25.4%at the end of the project.
2.Infant mortality rate in project counties dropped remarkably,and showed a more rapid decreasing than that of national countryside's average level.At the end of the project,the infant mortality rate in project counties was only 2.4%0 higher than national countryside's average level
3.Among all reported deaths,proportion of neonatal deaths was increasing,and the DFID trial counties and MCH intervention counties had the higher increase amplitude.
4.In project counties,proportion of male infant deaths was always larger than female infant deaths.The male infant mortality death was approximately the same with the female,both of which dropped from 39‰of early stage of project to 21‰of the end of project.
5.Proportion of infant death occurred at home was decreasing.From the view of gender,both the proportions of male and female infant death occurred at hospital was increasing,but the male part showed the higher increase amplitude.
6.During the project,more and more infant would seek treatment before death either in clinics or hospitals.Proportion of infant death that had not treatment seeking before death of DFID trial counties and MCH intervention counties was decreasing,but increasing in common project counties.
7.At the early stage of project,one fifth of infants did not do any diagnosis before death.In comparison,73%of infant got the diagnosis before death at the county level or above medical facilities.Proportion of infants that did not do any diagnosis before death in common project counties show a decreasing trend,but the lower amplitude than that of the other two types of counties.
8.Proportion of diagnosing cause of infant death by clinical methods was increasing steadily,and DFID trial counties and MCH intervention counties showed the higher increase amplitude.
9.Proportion and mortality rate of infectious diseases was decreasing gradually. Proportion and mortality rate of congenital abnormal diseases was increasing. Neonatal asphyxia became the first cause of infant deaths.Acatalepsy diseases occupied the 4~(th) place during the period of the project.
10.The results of multi-level analysis demonstrated that the influencing factors of infant mortality rate in project were year,systemic management of pregnant women,immunization coverage rate of four vaccines,crude birth rate.Besides, type of intervention and net income per capita of the farmers did not show the statistical correlation with the infant mortality rate.
Conclusions
1.The gap of infant mortality rate between project counties and national countryside's average level was reduced,which demonstrated that implementation of healthⅧproject efficiently promote the health of infant and accelerates the decreasing of infant mortality rate.
2.In the project areas,the utilization of maternal and child care was rising,with the higher proportion of neonatal deaths and lower threats of infectious diseases. Infant death profile of project areas is changing towards that of developed areas, and among the three types of interventions,DFID trial counties and MCH intervention counties displayed the more rapid transition.
3.In project areas,the decreasing of infant mortality rate is mainly because the implementation of project greatly improves the utilization of maternal and child care,and income has little impact on the infant mortality rate.
总体目标为评价卫生Ⅷ项目对于项目地区婴儿死亡的影响,具体目标为评估和确定项目县常规统计报告中的婴儿死亡率(IMR)数据的准确性;系统分析各类项目县婴儿死亡率的变化情况,包括分析比较不同贷款来源、不同干预措施的项目县的婴儿死亡特征(死亡年龄,死亡原因,性别、死亡地点等)的差异及整个项目期间的时间变化趋势;分析项目干预措施以及当地社会、经济等因素对项目地区婴儿死亡率的影响。
资料和方法
1.资料来源:本次研究所用资料主要有项目县逐年上报监督评价资料,现场调查漏报调查资料和本次评价期间收集的项目县婴儿死亡报告卡和人口学资料。
2.分析方法:一般性统计描述方法为主分析项目县婴儿死亡率变化及婴儿死亡特征变化,利用多水平重复测量模型分析婴儿死亡率的影响因素。
研究结果
1.项目地区的平均漏报率由前半阶段的27.8%降至项目后半段的25.4%,仅有轻微的下降趋势。
2.全部项目县的漏报校正后的婴儿死亡率在项目期间大幅下降,与全国农村地区婴儿死亡率的平均水平的差距逐渐缩小,至项目末期项目地区仅比全国农村地区高2.4‰。
3.新生儿死亡在全部婴儿死亡中比例提高,DFID试点县和MCH干预县提高的幅度要大于一般项目县。
4.在项目期间,项目地区死亡婴儿中男性的比例一直大于女性。男、女婴儿死亡率在整个项目期间基本相同,且在项目期间均有快速下降,由项目前期男、女婴儿的死亡率均在39‰左右降至项目末期的21‰以下。
5.死于医院的婴儿的比例不断上升。分性别来看,男性婴儿和女性婴儿死于医院的比例均在上升,且男性死亡婴儿中死于医院中的比例相对女性增加得更快。
6.项目地区婴儿死亡前曾经就诊于门诊和医院的比例在项目期间不断上升。按干预类型看,DFID试点县和MCH干预县未就医的比例在下降,而一般项目县未就医的比例小幅上升。
7.项目地区在项目早期有五分之一的婴儿死亡前未进行诊断,而在项目末期,有73%的婴儿在死亡前曾到过乡级或乡级以上的医院进行诊治。一般项目县中死前未进行诊断的比例下降幅度慢于其它两个类型的项目县。
8.项目地区通过临床诊断确诊婴儿死亡原因的比例不断增加。DFID试点县和MCH干预县通过临床诊断确定死因的比例的增幅要高于一般项目县。
9.项目地区感染性疾病的死因顺位和死亡率均为下降趋势:先天异常类死因的比例和死亡率呈上升趋势;新生儿窒息在项目末期成为项目地区婴儿死亡的第一位死因;诊断不明类的疾病在项目期间均排在第4位。
10.项目地区婴儿死亡率的影响因素为年份,孕产妇系统管理率,年内四苗接种率和项目地区粗出生率,而干预类型、农民人均纯收入等变量与婴儿死亡率没有统计学上的意义。
结论
1.项目地区的平均婴儿死亡率和全国农村的婴儿死亡率的平均水平的差距是在逐渐缩小的,说明卫生Ⅷ项目的实施可以提高项目地区的婴儿健康水平,项目的实施对于婴儿死亡率的下降是有明显效果的。
2.项目地区新生儿死亡的比例上升,婴儿死前的卫生服务利用水平提高,感染性疾病对于项目地区婴儿的死亡威胁在降低,项目地区婴儿死亡的特征向发达国家转变,MCH干预县和DFID试点县的死亡模式转变的速度和程度要优于一般项目县。
3.婴儿死亡率的影响因素分析表明,项目地区的婴儿死亡率的下降主要是因为提高了项目地区的孕产期的妇幼保健服务利用水平,同时在项目地区人均收入水平对于婴儿死亡率的影响并不显著。
Objective
The overall objective is to evaluate the impact of healthⅧproject on infant death. The specific objective are to analyze the trend of infant mortality rate in overall project counties,to compare the difference of infant death and times trend among the three type project counties,and explore the influencing factors of infant mortality rate.
Materials and Methods
1.Source of materials:In this study,we mainly use the three sources of data,which are monitoring data of project counties,underreporting data by household survey and collected infant death certificates and demographic data of project counties.
2.Methods:Descriptive statistical methods were used to analyze the trend of infant mortality rate and characteristics of infant death in project counties.Besides,in this study,we applied the multi-level model to explore the influencing factors of infant mortality rate of project counties.
Results
1.Underreporting rate of infant death dropped a little during the period of project, from 27.8%in the early stage to 25.4%at the end of the project.
2.Infant mortality rate in project counties dropped remarkably,and showed a more rapid decreasing than that of national countryside's average level.At the end of the project,the infant mortality rate in project counties was only 2.4%0 higher than national countryside's average level
3.Among all reported deaths,proportion of neonatal deaths was increasing,and the DFID trial counties and MCH intervention counties had the higher increase amplitude.
4.In project counties,proportion of male infant deaths was always larger than female infant deaths.The male infant mortality death was approximately the same with the female,both of which dropped from 39‰of early stage of project to 21‰of the end of project.
5.Proportion of infant death occurred at home was decreasing.From the view of gender,both the proportions of male and female infant death occurred at hospital was increasing,but the male part showed the higher increase amplitude.
6.During the project,more and more infant would seek treatment before death either in clinics or hospitals.Proportion of infant death that had not treatment seeking before death of DFID trial counties and MCH intervention counties was decreasing,but increasing in common project counties.
7.At the early stage of project,one fifth of infants did not do any diagnosis before death.In comparison,73%of infant got the diagnosis before death at the county level or above medical facilities.Proportion of infants that did not do any diagnosis before death in common project counties show a decreasing trend,but the lower amplitude than that of the other two types of counties.
8.Proportion of diagnosing cause of infant death by clinical methods was increasing steadily,and DFID trial counties and MCH intervention counties showed the higher increase amplitude.
9.Proportion and mortality rate of infectious diseases was decreasing gradually. Proportion and mortality rate of congenital abnormal diseases was increasing. Neonatal asphyxia became the first cause of infant deaths.Acatalepsy diseases occupied the 4~(th) place during the period of the project.
10.The results of multi-level analysis demonstrated that the influencing factors of infant mortality rate in project were year,systemic management of pregnant women,immunization coverage rate of four vaccines,crude birth rate.Besides, type of intervention and net income per capita of the farmers did not show the statistical correlation with the infant mortality rate.
Conclusions
1.The gap of infant mortality rate between project counties and national countryside's average level was reduced,which demonstrated that implementation of healthⅧproject efficiently promote the health of infant and accelerates the decreasing of infant mortality rate.
2.In the project areas,the utilization of maternal and child care was rising,with the higher proportion of neonatal deaths and lower threats of infectious diseases. Infant death profile of project areas is changing towards that of developed areas, and among the three types of interventions,DFID trial counties and MCH intervention counties displayed the more rapid transition.
3.In project areas,the decreasing of infant mortality rate is mainly because the implementation of project greatly improves the utilization of maternal and child care,and income has little impact on the infant mortality rate.
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36.张焕丽,董海燕,王丽等.婴儿死亡原因变化趋势及干预措施[J].中国妇幼保健,2005,20:796-797.
37.张仁力.从“五普”地市数据看生育政策对出生性别比和婴幼儿死亡率性别比的影响[J].人口研究,2005,29(1):11-18.
38.韩世红,李树茁.个人与家庭因素对中国儿童生存性别差异的影响研究[J].人口与经济,1999,2:28-34.
39.石玲,王燕.运用Hill-Upchurch标准分析中国九十年代婴儿幼儿死亡率的性别差异[J].人口研究,2002,26(2):29-34.
40.王惠珊,袁雪,闫淑娟等.北京市1992-2000年婴儿及胎婴儿死亡率的监测与干预研究[J].中华医学杂志,2001,81(23):1424-1426.
41.宋桂香,靳文正.上海市1995年婴儿死亡剖析[J].中国卫生统计,1998,15(4):43-44.
42.曲红明,邵秀风,俞效鲁.南京市城区1989-1990年婴儿死亡回顾调查与分析[J].中国卫生统计,1993,10(6):55.
43.张焕丽,董海燕,王丽.婴儿死亡原因及干预措施[J].中国妇幼保健,2005,20:796-797.
44.王少芳,王福钊.滨州市2000-2004年婴儿死亡回顾分析[J].中国妇幼保健,2006,21:2681-2682.
45.杨国珍,李壁,罗昭逊.贵州省农村地区1991-2002年婴儿死亡状况分析[J].中国妇幼保健,2005,20:789-793.
46.罗树生,王燕等.中国1998-2003年婴儿死亡率及其相关因素研究[J].中国妇幼保健,2006,21:841-1845.
1.Blaxter M.The health of children:a review of research on the place of health in cycles of disadvantage[J].London:Heinemann Educational,1981.
2.Murray CJL,Salomon JA,Mathers C.A critical examination of summary measures of population health[J].Bulletin World Health Organization,2000:78:981-994.
3.盛来运.中国婴儿死亡率现状及影响因素分析[J].人口与经济,1994,5:20-25.
4.婴儿死亡率和平均预期寿命[EB].http://www.stats.gov.cn/tjsj/qtsj/gjsj/2003/t20041110_402206708.htm.中华人民共和国统计局,2003.
5.江亦曼,张世琨译.世界若干国家(地区)的妇女教育指数与婴儿死亡率和总和生育率[M].[美]国际人口行动组织.
6.2000年全国各地区分性别的婴儿死亡率[EB]http://www.cpirc.org.cn/tjsj/tjsj_cy_detail.asp?id=3498.中国人口信息网
7.李希加.我国及各地区的婴儿死亡率与人口平均预期寿命(1990)[J].市场与人口分 析,1995,1(4):62-63.
8.郑晓瑛.中国死亡模式转变与国家卫生服务利用效率的关系[J].中国人口科学,2003,4:23-31.
9.Murray CJL.Rethinking DALYs.In;Murray CJL,Lopez AD,eds.The burden of disease:a comprehensive assessment of mortality and disability from disease,injuries,and risk factors in 1990 and project to 2020[J].Cambirdge,MA:Harvard School of Public Health,1996:1-98.
10.D D Reidpath,P Allotey.Infant mortality rate as an indicator of population health[J].Journal of Epidemiology and Community Health,2003,57(5):344-346.
11.张焕丽,董海燕,王丽等.婴儿死亡原因变化趋势及干预措施[J].中国妇幼保健,2005,20:796-797.
12.马葆靖,高清欣,刘随成等.1991-1996年河南省5岁以下儿童死亡监测及变化趋势[J].中国公共卫生,1998,14(11):684-685.
13.杨国珍,李壁,罗昭逊等.贵州省农村地区1991-2002年婴儿死亡状况分析[J].中国妇幼保健.2005,20:789-793.
14.朱雪娜,滕红红.北京市1999-2003年儿童死亡状况分析[J].中国妇幼保健,2005,20:2601-2603.
15.张焕丽,董海燕,王丽.婴儿死亡原因变化趋势及干预措施[J].中国妇幼保健,2005,20:796-797.
16.罗卫.1998-2002年桂林市5岁以下儿童死亡监测分析及对策[J].中国卫生统计,2005,22(1):32-34.
17.王少芳,王福钊.滨州市2000-2004年婴儿死亡回顾分析[J].中国妇幼保健,21(19):2681-2682.
18.JP Habicht,CG Victora,JP Vaughan.Evaluation designs for adequacy,plausibility and probability of public health program performance and impact[J].International Journal of Epidemiology,1999,28:10-18.
19.ABHAY T.BANG,RANI A.BANG,O.TALE,etc.Reduction in pneumonia mortality and total childhood mortality by means of community-based intervention trial in Gadchiroli,India[J].The Lancet,1990,336(8709):201-206.
20.K Anand,Shashi Kant,Guresh Kumar,etc.“Development” is not essential to reduce infant mortality rate in India:experience from the Ballabgarh project[J].Journal of Epidemiology and Community Health.,2000,54(4):247-253.
21.Amin,R.Immunization coverage and child mortality in two rural districts of Sierra Leone [J].Social Science and Medicine,1996.42(11):1599-604.
22.Abhay T.Bang,Hanimi M.Reddy,Mahesh D.Deshmukh,etc.Neonatal and Infant Mortality in the Ten Year(1993-2003) of the Gadchiroli Field Trial:Effect of Home-Based Neonatal Care[J].Journal of Perinatology,2005,25:S92-S107.
23.Nancy E.Williamson.An Attempt to Reduce Infant and Child Mortality in Bohol,Philippines[J].Studies in Family Planning,13(4):PP.106-117.
24.钱家珍,李海燕.广东省清远市5岁以下儿童、孕产妇死亡漏报调查及干预措施[J].中国初级卫生保健,1999,13(2):30-31.
25.周琳琳,周敬瑜.1991年广东省孕产妇死亡漏报分析[J].广东医学,1994,15(8):552-553.
26.周月标.江苏省1990年孕产妇死亡及活产监测漏报调查[J].江苏预防医学,1994,4:19-20.
27.林彬,郭俊,曾克芬等.克拉玛依市性传播疾病漏报调查及干预效果[J].中国公共卫生,2006,22(3):351.
28.张鑫培,章道存.上虞县1987-1988年居民死亡漏报调查[J].中国公共卫生,1991,7(7):323-324.
29.郑鸿,周兰萍,刘明等.攀枝花市2002年农村孕产妇死亡、五岁以下儿童死亡漏报调查报告[J].中国卫生事业管理,2003,8:496.
30.Wittes J.A generalization of the simple capture-recapture model with applications to epidemiological research[J].Journal of chronic diseases,1968,21(5):287-301.
31.Hilden J.Ascertainment corrected rates:Applications of capture-recapture methods [J].International Journal of epidemiology,1994,23(4):865-866.
32.仇成轩,施侣元.捕获-再捕获方法及其在流行病学中的应用[J].中华预防医学杂志,1998,32(1):54-55.
33.沈靖,高瞻.捕获-再捕获方法在流行病学发病率调查中的应用[J].江苏预防医学,1999,7:70-72.
34.M.D.Malison,E Sekeito,P.L.Henderson,etc.Estimating health service utilization,immunization coverage,and childhood mortality:a new approach in Uganda[J].Bulletin of the World Health Organization,65(3):325-330.
35.Jean-Francois Etard,Jean-Yves Le Hesran,Aldiouma Diallo,etc.Childhood mortality and probable causes death using verbal autopsy in Niakhar Senegal 1989-2000[J].International Journal of Epidemiology.,2004,33:1286-1292.
36.James Macinko,Frederico C Guanais,Maria de Fatima Marinho de Souza.Evaluation of the impact of the Family Health Program on infant mortality in Brazil,1990-2002[J].Journal of Epidemiology and Community Health.,2006,60:13-19.
37.聂富强,宋国军.中国婴儿死亡率控制:地区筹异、实证分析与政府干预[J].中国人口科学,2005,4:75-80.
38.郭素芳,王临虹,张文坤.中国贫困地区县级婴儿死亡率的多因素多水平分析[J].中国公共卫生,2001,17(6):558-560.
39.Brown,Haywood L,Watkins,Kevin,Hiett,Kinney A.Fetus-Placenta-Newborn:The impact of the Women Infants and Children Food Supplement Program on birth outcome[J].American Journal of Obstetrics and Gynecology,1996,174(4):PP1279-1283.
40.李晓松主译.多水平统计模型[M].四川:四川科学技术出版社,1999:1.
2.刘运国,刘谷琮主编.加强中国农村贫困地区基本卫生服务项目完工总结报告[R].北京:中国财政经济出版社,2007年6月.
3.郑晓瑛.中国死亡模式转变与国家卫生服务利用效率的关系[J].中国人口科学,2003,4:23-31.
4.王艳,缪蕾,钱幼琼等.1996至2000年全国5岁以下儿童死亡监测主要结果分析[J].中华预防医学杂忠,2005,39(4):260-264.
5.林良明,刘玉琳,冯士雍等.1991-1993年中国婴儿、5岁以下儿童死亡水平及趋势分析[J].人口研究,1996,20(4):50-56.
6.卫生部.项目对孕产妇死亡率和婴儿死亡率影响的分析.H8/SP项目终期评价任务书.2006年2月23日
7.JP Habicht,CG Victora,JP Vaughan.Evaluation designs for adequacy,plausibility and probability of public health programme performance and impact[J].International Journal of Epidemiology,1999,28:10-18.
8.Murray CJL,Salomon JA,Mathers C.A critical examination of summary measures of population health[J].Bulletin World Health Organization,2000:78:981-994.
9.Murray CJL.Rethinking DALYs.In;Murray CJL,Lopez AD,eds.The burden of disease:a comprehensive assessment of mortality and disability from disease,injuries,and risk factors in 1990 and project to 2020[J].Cambirdge,MA:Harvard School of Public Health,1996,1-98.
10.D D Reidpath,P Allotey.Infant mortality rate as an indicator of population health[J].Journal of Epidemiology and Community Health,2003,57(5):344-346.
11.葛正义,王亚东.安徽省卫生Ⅳ项目培训效益评价[J]。中国农村卫生事业管理,2003,23(8):32-34.
12.陈树珍,陈荔丽.广西卫Ⅳ项目实施与效果评价[J].中国妇幼保健,1999,14:514-516.
13.陈宁姗.社会经济发展对中国各省婴儿死亡率的影响[J].卫生经济研究,2003,2:9-11
14.ABHAY T.BANG,RANI A.BANG,O.TALE,etc.Reduction in pneumonia mortality and total childhood mortality by means of community-based intervention trial in Gadchiroli, India[J].The Lancet,1990,336(8709):201-206.
15.K Anand,Shashi Kant,Guresh Kumar,etc."Development" is not essential to reduce infant mortality rate in India:experience from the Ballabgarh project[J].Journal of Epidemiology and Community Health,2000,54(4):247-253.
16.Abhay T.Bang,Hanimi M.Reddy,Mahesh D.Deshmukh,etc.Neonatal and Infant Mortality in the Ten Year(1993-2003) of the Gadchiroli Field Trial:Effect of Home-Based Neonatal Care[J].Journal of Perinatology,2005,25:S92-S107.
17.Amin,R.Immunization coverage and child mortality in two rural districts of Sierra Leone.[J]Social Science and Medicine,1996.42(11):1599-604.
18.M.D.Malison,P.Sekeito,P.L.Henderson,etc.Estimating health service utilization,immunization coverage,and childhood mortality:a new approach in Uganda[J].Bulletin of the World Health Organization,65(3):325-330.
19.Nancy E.Williamson.An Attempt to Reduce Infant and Child Mortality in Bohol,Philippines [J].Studies in Family Planning,13(4):PP.106-117.
20.Jean-Francois Etard,Jean-Yves Le Hesran,Aldiouma Diallo,etc.Childhood mortality and probable causes death using verbal autopsy in Niakhar Senegal 1989-2000[J].International Journal of Epidemiology,2004,33:1286-1292.
21.李晓松主译.多水平统计模型[M].四川:四川科学技术出版社,1999:1.
22.张文彤,董伟.SPSS统计分析高级教程[M].北京:高等教育出版社,2004:77.
23.杨珉,李晓松.医学和公共卫生研究常用多水平统计模型[M].北京:北京大学医学出版社,2007:49-63.
24.钱家珍,李海燕.广东省清远市5岁以下儿童、孕产妇死亡漏报调查及干预措施[J].中国初级卫生保健,1999,13(2):30-31.
25.周琳琳,周敬瑜.1991年广东省孕产妇死亡漏报分析[J].广东医学,1994,15(8):552-553.
26.周月标.江苏省1990年孕产妇死亡及活产监测漏报调查[J].江苏预防医学,1994,4:19-20.
27.林彬,郭俊,曾克芬等.克拉玛依市性传播疾病漏报调查及干预效果[J].中国公共卫生,2006,22(3):351.
28.张鑫培,章道存.上虞县1987-1988年居民死亡漏报调查[J].中国公共卫生,1991,7(7):323-324.
29.郑鸿,周兰萍,刘明等.攀枝花市2002年农村孕产妇死亡、五岁以下儿童死亡漏报调查报告[J].中国卫生事业管理,2003,8:496.
30.Wittes J.A generalization of the simple capture-recapture model with applications to epidemiological research[J].Journal of chronic diseases,1968,21(5):287-301.
31.Hilden J.Ascertainment corrected rates:Applications of capture-recapture methods [J].International Journal of epidemiology,1994,23(4):865-866.
32.仇成轩,施侣元.捕获-再捕获方法及其在流行病学中的应用[J].中华预防医学杂志,1998,32(1):54-55.
33.沈靖,高瞻.捕获-再捕获方法在流行病学发病率调查中的应用[J].江苏预防医学,1999,7:70-72.
34.符文华,康晓平,谷渊,等.应用捕获-再捕获法估计5岁以下儿童死亡漏报及死亡率[J].中国卫生统计,2004,21(1):21-23
35.杨若玲.萍乡市5岁以下儿童死亡漏报调查[J].中国妇幼保健,2005,20(10):1253-1254.
36.张焕丽,董海燕,王丽等.婴儿死亡原因变化趋势及干预措施[J].中国妇幼保健,2005,20:796-797.
37.张仁力.从“五普”地市数据看生育政策对出生性别比和婴幼儿死亡率性别比的影响[J].人口研究,2005,29(1):11-18.
38.韩世红,李树茁.个人与家庭因素对中国儿童生存性别差异的影响研究[J].人口与经济,1999,2:28-34.
39.石玲,王燕.运用Hill-Upchurch标准分析中国九十年代婴儿幼儿死亡率的性别差异[J].人口研究,2002,26(2):29-34.
40.王惠珊,袁雪,闫淑娟等.北京市1992-2000年婴儿及胎婴儿死亡率的监测与干预研究[J].中华医学杂志,2001,81(23):1424-1426.
41.宋桂香,靳文正.上海市1995年婴儿死亡剖析[J].中国卫生统计,1998,15(4):43-44.
42.曲红明,邵秀风,俞效鲁.南京市城区1989-1990年婴儿死亡回顾调查与分析[J].中国卫生统计,1993,10(6):55.
43.张焕丽,董海燕,王丽.婴儿死亡原因及干预措施[J].中国妇幼保健,2005,20:796-797.
44.王少芳,王福钊.滨州市2000-2004年婴儿死亡回顾分析[J].中国妇幼保健,2006,21:2681-2682.
45.杨国珍,李壁,罗昭逊.贵州省农村地区1991-2002年婴儿死亡状况分析[J].中国妇幼保健,2005,20:789-793.
46.罗树生,王燕等.中国1998-2003年婴儿死亡率及其相关因素研究[J].中国妇幼保健,2006,21:841-1845.
1.Blaxter M.The health of children:a review of research on the place of health in cycles of disadvantage[J].London:Heinemann Educational,1981.
2.Murray CJL,Salomon JA,Mathers C.A critical examination of summary measures of population health[J].Bulletin World Health Organization,2000:78:981-994.
3.盛来运.中国婴儿死亡率现状及影响因素分析[J].人口与经济,1994,5:20-25.
4.婴儿死亡率和平均预期寿命[EB].http://www.stats.gov.cn/tjsj/qtsj/gjsj/2003/t20041110_402206708.htm.中华人民共和国统计局,2003.
5.江亦曼,张世琨译.世界若干国家(地区)的妇女教育指数与婴儿死亡率和总和生育率[M].[美]国际人口行动组织.
6.2000年全国各地区分性别的婴儿死亡率[EB]http://www.cpirc.org.cn/tjsj/tjsj_cy_detail.asp?id=3498.中国人口信息网
7.李希加.我国及各地区的婴儿死亡率与人口平均预期寿命(1990)[J].市场与人口分 析,1995,1(4):62-63.
8.郑晓瑛.中国死亡模式转变与国家卫生服务利用效率的关系[J].中国人口科学,2003,4:23-31.
9.Murray CJL.Rethinking DALYs.In;Murray CJL,Lopez AD,eds.The burden of disease:a comprehensive assessment of mortality and disability from disease,injuries,and risk factors in 1990 and project to 2020[J].Cambirdge,MA:Harvard School of Public Health,1996:1-98.
10.D D Reidpath,P Allotey.Infant mortality rate as an indicator of population health[J].Journal of Epidemiology and Community Health,2003,57(5):344-346.
11.张焕丽,董海燕,王丽等.婴儿死亡原因变化趋势及干预措施[J].中国妇幼保健,2005,20:796-797.
12.马葆靖,高清欣,刘随成等.1991-1996年河南省5岁以下儿童死亡监测及变化趋势[J].中国公共卫生,1998,14(11):684-685.
13.杨国珍,李壁,罗昭逊等.贵州省农村地区1991-2002年婴儿死亡状况分析[J].中国妇幼保健.2005,20:789-793.
14.朱雪娜,滕红红.北京市1999-2003年儿童死亡状况分析[J].中国妇幼保健,2005,20:2601-2603.
15.张焕丽,董海燕,王丽.婴儿死亡原因变化趋势及干预措施[J].中国妇幼保健,2005,20:796-797.
16.罗卫.1998-2002年桂林市5岁以下儿童死亡监测分析及对策[J].中国卫生统计,2005,22(1):32-34.
17.王少芳,王福钊.滨州市2000-2004年婴儿死亡回顾分析[J].中国妇幼保健,21(19):2681-2682.
18.JP Habicht,CG Victora,JP Vaughan.Evaluation designs for adequacy,plausibility and probability of public health program performance and impact[J].International Journal of Epidemiology,1999,28:10-18.
19.ABHAY T.BANG,RANI A.BANG,O.TALE,etc.Reduction in pneumonia mortality and total childhood mortality by means of community-based intervention trial in Gadchiroli,India[J].The Lancet,1990,336(8709):201-206.
20.K Anand,Shashi Kant,Guresh Kumar,etc.“Development” is not essential to reduce infant mortality rate in India:experience from the Ballabgarh project[J].Journal of Epidemiology and Community Health.,2000,54(4):247-253.
21.Amin,R.Immunization coverage and child mortality in two rural districts of Sierra Leone [J].Social Science and Medicine,1996.42(11):1599-604.
22.Abhay T.Bang,Hanimi M.Reddy,Mahesh D.Deshmukh,etc.Neonatal and Infant Mortality in the Ten Year(1993-2003) of the Gadchiroli Field Trial:Effect of Home-Based Neonatal Care[J].Journal of Perinatology,2005,25:S92-S107.
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