广州市荔湾区5岁以下儿童死因分析及相关干预对策

目的分析荔湾区5岁以下儿童死亡的主要原因,为进一步完善孕产妇保健管理和儿童保健管理模式提供依据。方法对2009~2013年荔湾区5岁以下儿童死亡资料及相关报表进行回顾性分析。结果 5年间荔湾区总人口的5岁以下儿童死亡率5.28‰,婴儿死亡率4.25‰,新生儿死亡率2.94‰,均维持在较低水平。流动人口的儿童死亡率大于常住人口儿童死亡率(χ2=30.341、15.431、5.679,P<0.05)且波动较大。常住人口的男童死亡率5.43‰大于女童3.42‰(χ2=6.371,P<0.05)。早产或低出生体重、其他新生儿病、其他先天异常、肺炎是5岁以下儿童主要死因。流动人口孕产妇孕期建卡、孕期保健覆盖率低,儿童保健管理覆盖率低。结论应制定相应措施,加强流动人口孕产妇与儿童的保健管理和健康宣教,提高孕妇的自我保健意识与获取保健的行为,向贫困的流动人口孕妇及儿童提供基本的免费保健服务,从而降低5岁以下儿童死亡。

Death cause analysis and corresponding intervention measures for children under 5 years old in Guangzhou city Liwan district

Objective To analyze the main death causes of children under 5 years old in Liwan District in order to pro- vide reference for further improvement of the maternal and child health management mode. Methods A retrospective analysis was conducted on data and reports of deceased children under 5 years old in Liwan District from 2009 to 2013. Results The mortality rates of children under 5 years old, the infant mortality rate and neonatal mortality rate in Liwan District over the past 5 years remained at a relatively low level, reaching 5.28%o, 4.25%o and 2.94%o respective- ly. The child mortality rate of floating populations was higher and more fluctuant than that of permanent residents （X2= 30.341, 15.431, 5.679, P〈0.05）. As for permanent residents, boys （5.43%o） had higher mortality rate than girls （3.42%o） （~2=6.371, P〈0.05）. Premature birth or low birth weight, other neonatal diseases, other congenital abnormalities and pneumonia were main death causes for children under 5 years old. As for floating populations, the pregnant and par- turient had low coverage of medical record and maternal health care during pregnancy and children had iow coverage of health management. Conclusion It is suggested to reduce the mortality rate of children under 5 years old from following aspects： to develop corresponding measures to enhance maternal and child health management and health education for floating populations; to motivate pregnant women to improve the awareness of self-health and gain access to health care; and to provide free essential health care for poor pregnant women and children among floating populations.