Objective To assess the completion of the under 5 mortality rate (U5MR) of Millennium Development Goals in 194 member countries of WHO, and to analyze the present situation of the global U5MR. Methods Based on the U5MR and the proportion of main causes of death in the "World Health Statistics 2015", the Millennium Development Goals of the decline of U5MR from 1990 to 2013 was assessed, the U5MR was analyzed by comparison between 2000 and 2013. Bivariate Pearson correlation analysis was used to determine the correlation between mortality and the ratio of infection to non infectious diseases and GDP per person in U5MR. Results By 2013, in 194 WHO member states, the U5MR in 46 (23.71%) countries achieved the millennium development goals. Comparison between 2000 and 2013, there was significant difference between low and high mortality groups in six continents (P<0.05), there was no significant difference between the moderate death groups (P>0.05), there was no significant difference in the ratio of infection to non infectious diseases between the middle and low mortality groups (P>0.05), however there was significant difference between the high mortality groups (P<0.05). There was significant difference in the average decline of U5MR and the ratio of non infectious diseases between low and medium, middle and high mortality groups (P<0.05). The Global U5MR had significant regional differences, the highest U5MR was in Africa, the lowest U5MR was in Europe, the medium U5MR was in North America, Oceania, South America, Asia was becoming the middle level. The U5MR was highly correlated with the ratio of infection to non-infectious diseases in every country (r2000y=0.934,r2013y=0.911,P<0.05), and it was low negatively correlated with GDP per capita (r2000y=–0.443,r2013y=–0.433,P<0.05). Conclusions There is a long way to reduce global child mortality. Prevention and control should focus on Africa and Asia. Prevention and control of infectious diseases is an effective measure for middle and high mortality countries. Prevention and control of non-infectious diseases is an important measure for low mortality countries. Increasing health investment is an important means to further reduce global U5MR.
ObjectiveTo systematically review the efficacy of promoting neonatal resuscitation technique in treatment of neonatal asphyxia in China. MethodsElectronical databases including WanFang Data, CNKI, VIP, Jiangsu Engineering and Technology Literature Information Center, PubMed and The Cochrane Library (Issue 5, 2016) were searched to collect studies of neonatal resuscitation technique in treatment of neonatal asphyxia up to June 1st, 2016. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using RevMan 5.2 software. ResultsA total of eighteen observational studies were included, involving 28 144 cases of neonatal asphyxia and 32 636 cases of control, 2 148 death cases of neonatal asphyxia and 1 679 cases of controls. The results of meta-analysis showed that neonatal resuscitation technique could reduce newborn suffocation rate compared with the control group in hospital surveys (RR=0.59, 95%CI 0.55 to 0.63, P<0.000 01) and in regional project surveys (RR=0.72, 95%CI 0.69 to 0.75, P<0.000 01). Neonatal resuscitation could also reduce neonatal asphyxia mortality rate in hospital surveys (RR=0.26, 95%CI 0.16 to 0.42, P<0.000 01) and in regional surveys (RR=0.65, 95%CI 0.55 to 0.77, P<0.000 01). ConclusionThe existing evidence shows that neonatal resuscitation technology could effectively reduce the incidence of neonatal asphyxia and mortality rate in China. Due to the limitations of the quantity and quality of present studies, we need to carry out prospective multicenter cohort studies to verify the current results.