拉丁美洲的儿童保健

C. Szwarcwald, M. Leal, W. Almeida, M. Barreto, P. Frias, M. T. Filha, R. Domingues, E. França, S. Gama, Cristiano Sigueira Boccolini, C. Victora
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引用次数: 5

摘要

儿童健康已被置于促进发展的国际倡议的前列。千年发展目标的通过推动了改善孕产妇和儿童健康的全球行动。在2000年期间,拉丁美洲国家在实施有效的新生儿和婴儿救生干预措施方面取得了显著进展。1990年至2015年期间,洛杉矶五岁以下儿童死亡率下降了三分之一,腹泻病和呼吸道感染的发病率大幅下降。由于该地区成功的免疫规划,一些疫苗可预防的疾病已被消灭。许多拉美国家几乎实现了由熟练人员助产的普遍覆盖,产前保健覆盖率超过80%。2015年,该区域18个国家报告消除了艾滋病毒和梅毒母婴传播。虽然旨在促进拉丁美洲国家儿童健康和发展的公共议程取得进展是不可否认的,但仍存在未解决的问题。虽然可以通过改善产前、产中和产后干预措施来避免许多死产和新生儿死亡,但拉丁美洲的剖宫产率在世界所有区域中是最高的,而且在没有医疗指征的情况下进行的剖宫产手术数量过多。洛杉矶国家同时出现的剖宫产不足和过剩反映出一种将相当一部分人口排除在外的护理模式,并揭示了该地区持续存在的差距和不平等。面临的主要挑战之一是缺乏可持续的筹资机制,无法向所有儿童提供综合和高质量的保健、平等的教育机会和支持处境不利家庭的社会服务。在规划干预措施时,应恢复公平作为确保包容和社会正义的行动指导原则。在拉丁美洲和其他地方,儿童代表着社会的未来。因此,提供普遍儿童健康的社会承诺是可持续发展的根源,必须成为绝对优先事项。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Child Health in Latin America
Child health has been placed at the forefront of international initiatives for development. The adoption of the Millennium Development Goals has propelled worldwide actions to improve maternal and child health. In the course of the year 2000, the Latin American (LA) countries made marked progress in implementing effective newborn and infant life-saving interventions. Under-five mortality in LA fell by a third between 1990 and 2015, with a sharp decline in diarrheal diseases and respiratory infections. Due to the successful immunization programs in the region, some vaccine-preventable diseases have been eliminated. Many of the LA countries have reached nearly universal coverage of childbirths attended by skilled personnel and >80% coverage for antenatal care. In 2015, 18 countries in the region reported the elimination of mother-to-child transmission for both HIV and syphilis. Although the advances in the public agenda aimed at promoting child health and development in Latin American countries are undeniable, unresolved issues remain. While many stillbirths and neonatal deaths could be averted by improving access to antenatal, intra-partum, and postnatal interventions, Latin America has the highest cesarean rate among all regions of the world with an excessive number of such operations without medical indications. The simultaneous lack and excess of cesarean deliveries in LA countries reflects a model of care that excludes a considerable portion of the population and reveals the persistent gaps and inequalities in the region. One of the main challenges to be faced is the lack of sustainable financing mechanisms to provide integrated and high-quality health care to all children, equal education opportunities, and social services to support disadvantaged families. When planning interventions, equity should be restored as the guiding principle of actions to ensure inclusion and social justice. Children represent the future of society in Latin America and elsewhere. For this reason, social commitment to provide universal child health is the genesis of sustainable development and must be an absolute priority.
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