تحلیل ارتباط نهاده‌های بهداشتی بر مرگ ‌‌و میر کودکان براساس ضریب جینی و منحنی لورنز

محورهای موضوعی : -مدارک پزشکی

فاطمه کریم نژاد رمی ¹ , قهرمان محمودی ² , محمدعلی جهانی ³

1 - کارشنا‌سی‌ارشد مدیریت خدمات بهداشتی و درمانی، واحد ساری، دانشگاه آزاد اسلامی، ساری، ایران
2 - دانشیار، گروه مدیریت خدمات بهداشتی و درمانی، واحد ساری، دانشگاه آزاد اسلامی، ساری، ایران
3 - دانشیار، مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی بابل، بابل، ایران

تاریخ دریافت : 1398/02/19 تاریخ پذیرش : 1398/03/18 تاریخ انتشار : 1398/03/01

کلید واژه: مرگ و میر نوزادان, مرگ و میر کودکان, نابرابری,

چکیده مقاله :

مقدمه:مرگ و میر کودکان یکی از مهم ترین شاخص های بهداشتی، فرهنگی و اقتصادی در ارزیابی سلامت جامعه می‌باشد. هدف از این پژوهش تحلیل ارتباط نهاده‌های بهداشتی بر مرگ و میر کودکان براساس ضریب جینی و منحنی لورنز بوده است. روش پژوهش: مطالعه حاضر توصیفی از نوع اکولوژیک بوده که به برابری یا نابرابری توزیع امکانات بهداشتی در سطح شهرستان‌های استان مازندران براساس شاخص‌های جمعیتی سال 1395 پرداخته است. جامعه پژوهش شامل مراکز بهداشتی و درمانی، پایگاه‌های بهداشتی، خانه‌های بهداشتی، کارکنان بهداشتی، پایگاه‌های اورژانس وتعداد کارکنان این مراکز بوده است، پس از جمع‌آوری داده‌ها از معاونت بهداشتی دانشگاه‌های علوم پزشکی استان مازندران و بابل تحلیل داده‌ها توسط نرم‌افزارهای Dasp2.1 ،STATA وSPSS19 انجام شد. یافته‌ها: ضریب جینی توزیع مراکز بهداشتی روستایی برحسب جمعیت 0.32 در مراکز بهداشتی و درمانی شهری 0.28 بود. ضریب جینی توزیع پایگاه‌های بهداشتی، خانه‌های بهداشت و کارکنان بخش بهداشتی بالای 0.3 بوده است. بین نسبت مراکز بهداشتی روستایی به جمعیت با مرگ و میر نوزادان (0.895- = r، 0.03= p-value ) وکودکان زیر پنج سال(0.901- = r، 0.01= p-value ) و بین نسبت خانه‌های بهداشتی به جمعیت با مرگ و میر نوزادان (0.367- = r، 0.03= p-value ) وکودکان زیر پنج سال(0.489- = r ، 0.03= p-value ) ارتباط معنی‌داری وجود داشت. نتیجه‌گیری: نابرابری درتوزیع برخی نهاده‌های بهداشتی وجود داشت که با توجه به ارتباط بین نهاده‌های بهداشتی با مرگ و میر کودکان و نوزادان،پیشنهاد می‌گردد توجه به درجه توسعه‌یافتگی شهرستان‌ها و میزان برخورداری از این شاخص‌ها در اولویت قرار گیرد.

چکیده انگلیسی:

Introduction: Child mortality is one of the most important cultural, economic and health indicators in evaluating the health status of the community. This study aimed to analyze the relationship between health centers with the child mortality based on the Gini coefficient and Lorenz curve. Methods: This ecological descriptive study was conducted in 2016 to examine the equality or inequality in the distribution of health facilities in the cities of Mazandaran province based on demographic indicators. The research population consisted of health centers, health personnel, emergency centers and the number of employees in these centers. After collecting data from the Ministry of Health of Mazandaran and babol University of Medical Sciences, the obtained data was analyzed using Dasp2.1, STATA and SPSS19 software. Results: Gini coefficient for the distribution of rural health centers was 0.28 and 0.32 for urban health centers, based on population. The Gini coefficient for distribution of health centers and health personnel was higher than 0.3. There was a significant relationship between the ratio of rural health centers to the population and child mortality (r = -0.853, p-value = 0.03) of children under five years old (r = -0.901, p-value = 0.01), and between the ratio of health centers to population and child mortality (r = -0.367; p-value = 0.03) of children under five years old (r = 0.489, p-value = 0.03). Conclusion: Since a significant level of inequality was found in the distribution of some health centers, considering the relationship between health centers and child mortality.

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