دانلود مقاله رویکردی مبتنی بر حقوق زنان برای کاهش مرگ و میر کودکان
چکیده
اهمیت
زمینه
روش ها
نتایج
بحث
نتیجه گیری
منابع
Abstract
Significance
Background
Methods
Results
Discussion
Conclusion
References
چکیده
اهداف
سلامت و تندرستی مادر به طور قابل توجهی بر سلامت کودک تأثیر می گذارد. استقلال زنان می‌تواند رفتار جستجوی مراقبت‌های بهداشتی، استفاده از خدمات مراقبت‌های بهداشتی و بارداری برنامه‌ریزی شده را بهبود بخشد و در نتیجه سلامت کودک را بهبود بخشد. نرخ جهانی مرگ و میر زیر پنج سال (U5MR) سریع ترین کاهش را در دو دهه گذشته داشته است، اما تأثیر برابری جنسیتی بر مرگ و میر کودکان بررسی نشده است. یک رویکرد استراتژیک برای رسیدگی به برابری جنسیتی برای کاهش بیشتر U5MR مورد نیاز است. هدف این مطالعه شناسایی و بررسی ارتباط بین شاخص‌های برابری جنسیتی و U5MR با استفاده از رویکرد مبتنی بر حقوق بشر بود.
مواد و روش ها
ما داده‌های ثانویه منبع باز از آژانس‌های بین‌المللی را که شامل 521 متغیر حساس به جنسیت برای 193 کشور است، تجزیه و تحلیل کردیم. نه متغیر برای مدل معادلات ساختاری نهایی بر اساس مدل نظری گنجانده شد. مدل 1 شامل 193 کشور بود و مدل 2 شامل تجزیه و تحلیل زیر گروهی از 11 متغیر برای 158 کشور بود. برابری جنسیتی یک متغیر پنهان بود و U5MR متغیر نتیجه بود.
نتایج
برابری جنسیتی به طور قابل‌توجهی با U5MR مرتبط بود (Z = − 7.47، 95% CI = − 754.67 تا 440.98-، p < 0‧001، n −= -193 برای مدل 1، −8. 480.72، p < 0‧001، n = 158 برای مدل 2). تحصیلات زنان، اشتغال زنان با حقوق و دستمزد، زنان به عنوان کارفرما، و نمایندگی زنان در رهبری و پارلمان، برابری جنسیتی را افزایش دادند، در حالی که شیوع ازدواج کودکان و خشونت شریک صمیمی (IPV) بر برابری جنسیتی تأثیر منفی گذاشت. بهبود در برابری جنسیتی به طور قابل توجهی U5MR را کاهش داد.
نتیجه گیری برای تمرین
بهبود موقعیت اقتصادی، آموزشی و اجتماعی زنان و افزایش حضور زنان در پست‌های رهبری و سیاست‌گذاری بالاتر، کلید کاهش مرگ و میر کودکان است. قابل ذکر است که حذف ازدواج کودکان و IPV کلید دستیابی به برابری جنسیتی است و در خط مقدم سیاست های ملی مورد نیاز است. برابری جنسیتی می تواند به طور قابل توجهی استقلال باروری زنان را بهبود بخشد، که عاملی حیاتی در بهبود استفاده از مراقبت های بهداشتی برای زنان و فرزندانشان است.
توجه! این متن ترجمه ماشینی بوده و توسط مترجمین ای ترجمه، ترجمه نشده است.
Abstract
Objectives
Mother’s health and wellbeing significantly affects child health. Women’s autonomy can improve healthcare-seeking behaviour, utilisation of healthcare services, and planned pregnancy, thereby improving child health. The global under-five mortality rate (U5MR) has seen the fastest decline in the past two decades, but the influence of gender equality on child mortality remains unaddressed. A strategic approach addressing gender equality is needed to reduce the U5MR further. The study aimed to identify and investigate the association between indicators of gender equality and U5MR using a human rights-based approach.
Methods
We analysed open-source secondary data from international agencies comprising 521 gender-sensitive variables for 193 countries. Nine variables were included for the final Structural Equation Model based on the theoretical model. Model 1 consisted of 193 countries, and Model 2 comprised a subgroup analysis of 11 variables for 158 countries. Gender equality was a latent variable, and the U5MR was the outcome variable.
Results
Gender equality was significantly associated with U5MR (Z = − 7.47, 95% CI = − 754.67 to − 440.98, p < 0‧001, n = 193 for Model 1, and Z = − 7.71, 95% CI = − 808.26 to − 480.72, p < 0‧001, n = 158 for Model 2). Female education, women’s waged and salaried employment, women as employers, and women’s representation in leadership and parliament enhanced gender equality, whereas the prevalence of child marriage and intimate partner violence (IPV) negatively affected gender equality. Improvement in gender equality significantly reduced U5MR.
Conclusions for practice
Improving women’s economic, educational, and social position and increasing female representation in higher leadership and policymaking positions is the key to reducing child mortality. Notably, eliminating child marriage and IPV is the key to achieving gender equality and is needed at the forefront of national policies. Gender equality can significantly improve women’s reproductive autonomy, a critical factor in improving healthcare utilisation for women and their children.
Introduction
A child’s death is a traumatic experience for a family. The grief of losing a child is an agonising event that may cause long-term negative consequences to the mother’s health and wellbeing (Raitio et al., 2015). The global under-fve mortality rate (U5MR) was 42.5 per 1000 live births in 2015, translating to approximately 16,000 deaths per day, which is half of what it was in 1990 (You et al., 2015). However, the non-medical causes of the U5MR remained unaccounted for in the global statistics. Non-medical reasons of U5MR, such as armed conficts, natural disasters, economic crises, political instability, repression due to abuse, domestic violence, feticides, and infanticides, afected the lives of millions of children during the past two decades. From 1995 to 2015, in Africa alone, more than 200,000 under-fve child deaths were attributed to armed conficts (Wagner et al., 2018). In 2016, female infanticide was responsible for 1.5 million deaths annually in more than 11 countries (ACHR, 2016). Moreover, female children are not given the same amount of care and attention to nutrition and health needs by parents in countries with strong son-bias, thereby afecting their long-term health (ACHR, 2016). Unintended pregnancy is another non-medical risk signifcantly associated with child mortality (Gipson et al., 2008). Poor antenatal care, lower breastfeeding practices and attention to nutritional needs are some of the potential efects of unintended pregnancies that directly afect child health (Gipson et al., 2008).
Conclusion
The results of this study provide compelling evidence for policymakers and researchers. Policies to improve funding for the higher education of women, creating more opportunities for paid employment for women, drastically increasing women’s representation in politics and leadership, reducing IPV, and ending child marriages can substantially reduce under-fve child mortality. A paradigm shift from a diseasebased approach to a women’s rights-based approach towards maternal and child health policies is needed if the world achieves the SDGs’ child mortality targets. Several studies are still required to understand the multitude of problems faced by women globally. This study highlighted the need to improve data reporting of gender-based variables and simplify the extensive list of variables. Researchers can use the list of variables identifed in this study to report on the progress of gender equality. Accelerated eforts are also needed to end child marriage and violence against women before the end of the SDGs and should be a primary goal of all countries over the next few years. The achievement of the SDGs will need a human rights-based approach, which is challenging but not impossible.