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首页> 美国卫生研究院文献>Global Health Action >Measuring child survival for the Millennium Development Goals in Africa: what have we learned and what more is needed to evaluate the Sustainable Development Goals?
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Measuring child survival for the Millennium Development Goals in Africa: what have we learned and what more is needed to evaluate the Sustainable Development Goals?

机译：为非洲的千年发展目标衡量儿童的生存：我们学到了什么还需要更多什么来评估可持续发展目标？

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Reducing child mortality is a key global health challenge. We examined reasons for greater or lesser success in meeting under-five mortality rate reductions, i.e. Millennium Development Goal #4, between 1990 and 2015 in Sub-Saharan Africa where child mortality remains high. We first examined factors associated with child mortality from all World Health Organization African Region nations during the Millennium Development Goal period. This analysis was followed by case studies of the facilitators and barriers to Millennium Development Goal #4 in four countries – Kenya, Liberia, Zambia, and Zimbabwe. Quantitative indicators, policy documents, and qualitative interviews and focus groups were collected from each country to examine factors within and across countries related to child mortality. We found familiar themes that highlighted the need for both specific services (e.g. primary care access, emergency obstetric and neonatal care) and general management (e.g. strong health governance and leadership, increasing community health workers, quality of care). We also identified methodological opportunities and challenges to assessing progress in child health, which can provide insights to similar efforts during the Sustainable Development Goal period. Specifically, it is important for countries to adapt general international goals and measurements to their national context, considering baseline mortality rates and health information systems, to develop country-specific goals. It will also be critical to develop more rigorous measurement tools and indicators to accurately characterize maternal, neonatal, and child health systems, particularly in the area of governance and leadership. Valuable lessons can be learned from Millennium Development Goal successes and failures, as well as how they are evaluated. As countries seek to lower child mortality further during the Sustainable Development Goal period, it will be necessary to prioritize and support countries in quantitative and qualitative data collection to assess and contextualize progress, identifying areas needing improvement.
机译：降低儿童死亡率是全球健康的关键挑战。我们研究了在1990年至2015年间撒哈拉以南非洲儿童死亡率仍然很高的目标，他们在实现5岁以下儿童死亡率降低方面取得或多或少成功的原因。我们首先研究了在千年发展目标时期内所有世界卫生组织非洲区域国家与儿童死亡率相关的因素。进行此分析之后，对四个国家（肯尼亚，利比里亚，赞比亚和津巴布韦）的推动者和实现千年发展目标4的障碍进行了案例研究。从每个国家收集了定量指标，政策文件，定性访谈和焦点小组，以检查国家内部或国家之间与儿童死亡率有关的因素。我们发现熟悉的主题突出了对特定服务（例如初级保健，产科和新生儿急诊）和一般管理（例如强大的卫生治理和领导力，增加的社区卫生工作者，护理质量）的需求。我们还确定了评估儿童健康进展的方法学机遇和挑战，可以为可持续发展目标时期的类似工作提供见识。具体而言，对于各国而言，重要的是要考虑到基线死亡率和健康信息系统，使总体国际目标和衡量标准适应其国情，以制定针对特定国家的目标。开发更严格的测量工具和指标以准确表征孕产妇，新生儿和儿童卫生系统，特别是在治理和领导力方面，也至关重要。可以从千年发展目标的成败以及如何对其进行评估中吸取宝贵的经验教训。随着各国寻求在可持续发展目标期间进一步降低儿童死亡率，有必要在收集定量和定性数据方面对各国进行优先排序和支持，以评估进展情况并根据情况确定需要改进的领域。

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