摘要:
目的 研究西藏自治区实现《2030年可持续发展议程》17项可持续发展目标(SDGs)中妇幼卫生指标的进程,分析西藏自治区面临的挑战和对策. 方法 利用1991—2017年全国和西藏自治区统计年鉴数据,从中提取历年有可利用数据的西藏和全国妇幼卫生指标数据,对于某些年份的缺失数据,运用插值法进行估计.描述西藏自治区孕产妇、儿童死亡率变化趋势及与全国平均水平的差距,分析西藏自治区妇幼卫生和社会经济发展对妇幼健康水平的影响,根据历史数据发展趋势预测西藏自治区实现 SDGs 妇幼卫生指标的进程. 结果 1990—2015年西藏自治区孕产妇死亡率、婴儿和5岁以下儿童死亡率显著下降,平均年下降速率分别为7. 6%、7. 0%和7. 1%,如期实现了《联合国千年宣言》中的8 项千年发展目标(MDGs),妇幼死亡率与全国平均水平的差距不断缩小.在此期间,西藏自治区妇幼卫生服务水平的提高和社会经济的迅速发展,对孕产妇和儿童健康水平的改善作出了积极贡献.按照死亡率历年变化趋势,西藏自治区孕产妇死亡率将于2023年实现SDGs目标;西藏自治区新生儿、5岁以下儿童死亡率已于2014年、2013年实现SDGs目标. 结论 西藏自治区妇幼健康状况显著改善,孕产妇和儿童死亡率指标能够如期达到SDGs要求,对妇幼卫生建设和社会经济发展的大力援助和积极干预能够加速SDGs实现进程.%Objective To investigate the process in achieving maternal and child health (MCH)indicators under seventeen sustainable development goals (SDGs)of 2030 agenda,analyze challenges and provide strategies for achieving goals of Tibet Autonomous Region. Methods Using data from statistical yearbooks of China and Tibet from 1991 to 2017,we extracted available data from Tibetan and national maternal and child health indicators,and estimated the missing data with interpolation method.We described the trend of maternal and child mortality in Tibet as well as its gap with the national average,analyzed the impact of MCH services and socioeconomic development on MCH status,and predicted Tibet's process towards SDGs based on historical data. Results From 1990 to 2015,there was a significant reduction of maternal mortality rate (MMR),infant mortality rate (IMR)and under-5 mortality rate (U5MR)in Tibet with average annual reduction rates of 7.6%,7.0% and 7.1% respectively.Tibet achieved MCH indicators under MDGs on schedule and the disparities between Tibet and the national average in maternal and child mortality continued decreasing,which was largely attributed to the rapid improvement of MCH services and socioeconomic development.As for SDGs,NMR and U5MR indicators had been achieved in 2014 and 2013 in Tibet,MMR indicator was estimated to be achieved in 2023 based on historical trends. Conclusion Tibet is on track to achieve MCH indicators under SDGs with significantly improved MCH status.Health assistance and active interventions on MCH and socioeconomic development can accelerate the progress towards SDGs.