1992—2005年蒙古国土地利用变化及其驱动因素

基于1992、2002年遥感图像以及2001、2005年的MODIS影像,结合相关统计资料,研究了蒙古国土地利用变化的总体特征、土地利用变化的空间差异,并对其驱动因素进行了分析.结果表明：1992—2005年,研究区耕地和林地面积明显减少,建设用地和未利用土地面积呈增加趋势,水域面积略有减少,草地面积相对稳定,但质量有所下降;2001—2005年,蒙古国土地利用变化的区域差异明显,西部山区和南部戈壁区北部是全国土地利用变化最集中的区域;研究区土地利用变化的主要驱动力为包括气候变化和自然灾害在内的自然因子以及政策法规、人口增加等社会经济因子.     

The Maternal and Child Health (MCH) Handbook in Mongolia: A Cluster-Randomized,Controlled Trial

Objective

To assess the effectiveness of the Maternal and Child Health (MCH) handbook in Mongolia to increase antenatal clinic attendance, and to enhance health-seeking behaviors and other health outcomes.

Methods

A cluster randomized trial was conducted using the translated MCH handbook in Bulgan, Mongolia to assess its effectiveness in promoting antenatal care attendance. Pregnant women were recruited from 18 randomly allocated districts using shuffled, sealed envelopes. The handbook was implemented immediately for women at their first antenatal visit in the intervention group, and nine months later in the control group. The primary outcome was the number of antenatal care visits of all women residing in the selected districts. Cluster effects were adjusted for using generalized estimation equation. Masking was not possible among care providers, pregnant women and assessors.

Findings

Nine districts were allocated to the intervention group and the remainder to the control group. The intervention group (253 women) attended antenatal clinics on average 6•9 times, while the control group (248 women) attended 6•2 times. Socioeconomic status affected the frequency of clinic attendance: women of higher socioeconomic status visited antenatal clinics more often. Pregnancy complications were more likely to be detected among women using the handbook.

Conclusion

The MCH handbook promotes continuous care and showed an increase in antenatal visits among the intervention group. The intervention will help to identify maternal morbidities during pregnancy and promote health-seeking behaviors.

Trial Registration

UMIN Clinical Trial Registry UMIN000001748