Sức khỏe bà mẹ, trẻ sơ sinh và trẻ dưới 5 tuổi ở Đông Nam Á: HƯỚNG TỚI HỢP TÁC KHU VỰC CHẶT CHẼ HƠN
Tóm tắt
Mặc dù tử vong bà mẹ và trẻ em đang trên đà giảm ở Đông Nam Á, tuy nhiên mức giảm không đồng đều. Đảm bảo công bằng là chìa khóa để đạt được Mục tiêu Phát triển Thiên niên kỷ. Trong bài báo này chúng tôi sử dụng dữ liệu có thể so sánh được giữa các quốc gia theo từng thời điểm, chứng minh xu hướng giảm tử vong từ năm 1990 đến năm 2008 nhằm đánh giá các nguyên nhân chính gây tử vong ở bà mẹ và trẻ em. Sự bất bình đẳng trong bao phủ các can thiệp thể hiện qua hai đo lường phổ biến là phân nhóm giàu - nghèo và phân nhóm thành thị - nông thôn. Nghiên cứu trường hợp giảm tỷ lệ tử vong ở Thái Lan và Indonesia cho thấy mức độ thành công khác nhau của các can thiệp cũng như một số yếu tố thúc đẩy giảm tử vong. Chúng tôi xây dựng Công cụ phân tích cứu sống (Lives Saved Tool Analysis) theo vùng và theo nhóm nước để ước lượng tỷ lệ tử vong có thể phòng ngừa theo nguyên nhân và theo can thiệp. Ba mô hình giảm tử vong bà mẹ và trẻ em trong khu vực được xác định là: điểm xuất phát sớm, xu hướng đi xuống nhanh (ở Brunei, Singapore, Malaysia và Thái Lan), giảm nhiều giai đoạn đầu (bền vững ở Việt Nam nhưng có sự dao động ở Philippines và Indonesia), tỷ lệ xuất phát điểm cao và có xu hướng đi xuống (ở Lào, Campuchia và Myanmar). Phát triển kinh tế dường đã tạo điều kiện quan trọng là phải đi kèm với mở rộng hơn các can thiệp của hệ thống y tế. Hệ thống y tế cần được quan tâm và mở rộng độ bao phủ hơn nữa. Hiệp hội các Quốc gia Đông Nam Á (Association of Southeast Asian Nations, ASEAN) cũng cần đẩy mạnh thực hiện chính sách để đạt được các mục tiêu về sức khỏe của bà mẹ, trẻ sơ sinh và trẻ em.
Từ khóa
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