π‘æπ∏åμâπ©∫—∫
Original Article
816
∫∑§—¥¬àÕ ªí®®ÿ∫—π ∂“π°“√≥å°“√쓬„π‡¥Á°¢Õߪ√–‡∑»‰∑¬π—Èππ—∫«à“¥’¢÷Èπμ“¡≈”¥—∫ ‚¥¬æ∫«à“Õ—μ√“쓬∑“√°
·≈–‡¥Á°μË”°«à“ 5 ªïÕ¬Ÿà„π‡°≥±å§àÕπ¢â“ßμË” Õ¬à“߉√°Áμ“¡ Õ—μ√“°“√쓬„π‡¥Á°„πæ◊Èπ∑’Ëμà“ß Ê ¢Õߪ√–‡∑»
‰∑¬¬—ß·μ°μà“ß°—π‰ª °“√»÷°…“π’È®÷ßμâÕß°“√‡ª√’¬∫‡∑’¬∫ ∂“π°“√≥å°“√쓬¢Õ߇¥Á°„π√–¥—∫®—ßÀ«—¥ ·≈–
§âπÀ“ªí®®—¬‡∫◊ÈÕßμâπ∑’Ë —¡æ—π∏å°—∫°“√쓬 ‚¥¬»÷°…“®“°¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥凥Á°„πª√–‡∑»‰∑¬ æ.».
2548 - 2549 ·≈–„™â«‘∏’ª√–¡“≥°“√쓬‡¥Á°∑“ßÕâÕ¡®“°®”π«π∫ÿμ√‡°‘¥√Õ¥ ·≈–®”π«π∫ÿμ√∑’Ë¡’™’«‘μÕ¬Ÿà¢Õß μ√’Õ“¬ÿ 15-49 ªï μ“¡«‘∏’¢Õß∫√“ å∑’˪√—∫‚¥¬∑√— ‡´≈≈å
°“√»÷°…“æ∫«à“Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï „π 24 ®“° 26 ®—ßÀ«—¥∑’Ë»÷°…“Õ¬Ÿà„π™à«ß 4.8 (95%CI 4.1, 5.5) - 37.1 (95%CI 29.1, 35.1) μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬ ®—ßÀ«—¥√“™∫ÿ√’‡ªìπ®—ßÀ«—¥∑’Ë¡’Õ—μ√“μË”∑’Ë ÿ¥„π
¢≥–∑’Ë®—ßÀ«—¥π√“∏‘«“ ‡ªìπ®—ßÀ«—¥∑’Ëæ∫Õ—μ√“ Ÿß∑’Ë ÿ¥ Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï„π√–¥—∫®—ßÀ«—¥¡’§«“¡
—¡æ—π∏å„π∑“ß≈∫Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘μ‘ (r = -0.413, p < 0.05) °—∫§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π
¢Õ߇¥Á°„π®—ßÀ«—¥π—Èπ Ê ¥—ßπ—Èπ ‡æ◊ËÕ„Àâ¿“«–°“√쓬„π‡¥Á°≈¥≈ß °“√√≥√ߧå‡æ◊ËÕ„À⇥Á°·≈–∑“√°∑ÿ°√“¬‰¥â
√—∫«—§´’πÕ¬à“ߧ√∫∂â«π¬—ߧßμâÕߥ”‡π‘πμàÕ‰ª‚¥¬‡©æ“–„π°≈ÿࡺŸâ¥âÕ¬‚Õ°“ ∑—ÈßÀ≈“¬
§” ”§—≠: §«“¡·μ°μà“ß°—π¢Õß°“√쓬 °“√쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï
§«“¡·μ°μà“ß„π√–¥—∫®—ßÀ«—¥¢Õß°“√쓬
‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï
ªí∑¡“ «à“æ—≤π«ß»å
∂“∫—π«‘®—¬ª√–™“°√·≈– —ߧ¡ ¡À“«‘∑¬“≈—¬¡À‘¥≈
∫∑π”
ªí≠À“ ”§—≠Õ¬à“ßÀπ÷Ëß ”À√—∫ª√–‡∑»°”≈—ßæ—≤π“
∑—ÈßÀ≈“¬ §◊Õ ªí≠À“°“√쓬„π∑“√°·≈–‡¥Á°∑’ˬ—ß§ß Ÿß Õ¬Ÿà„πÀ≈“¬ª√–‡∑»·¡â«à“®–¡’°“√¥”‡π‘πß“π‡æ◊ËÕ·°â ‰¢
ªí≠À“π’ÈÕ¬à“ßμàÕ‡π◊ËÕ߬“«π“π ®π°√–∑—Ëß°“√ª√–™ÿ¡
ÿ¥¬Õ¥¢ÕßÕߧ尓√ Àª√–™“™“μ‘«à“¥â«¬‡ªÑ“À¡“¬°“√
æ—≤π“·Ààß À— «√√…‡¡◊ËÕ°—𬓬π 2543 ‰¥â∫√√®ÿ‡√◊ËÕß
°“√≈¥Õ—μ√“쓬¢Õ߇¥Á°„À⇪ìπ‡ªÑ“À¡“¬Àπ÷ËߢÕß°“√
æ—≤π“·Ààß À— «√√…* ®“°°“√μ‘¥μ“¡¿“«–°“√쓬„π
‡¥Á° ªí®®ÿ∫—πæ∫«à“°«à“ 80 ª√–‡∑»„π‚≈°π’È∑’ˬ—ߧߡ’
*‡ªÑ“À¡“¬°“√æ—≤π“·Ààß À— «√√… (Millennium Development Goals) ª√–°Õ∫¥â«¬ ‡ªÑ“À¡“¬∑’ËÀπ÷Ëß: ¢®—¥§«“¡¬“°®π·≈–§«“¡À‘«‚À¬ ‡ªÑ“À¡“¬∑’Ë Õß:
„À⇥Á°∑ÿ°§π‰¥â√—∫°“√»÷°…“√–¥—∫ª√–∂¡»÷°…“ ‡ªÑ“À¡“¬∑’Ë “¡: à߇ √‘¡∫∑∫“∑ μ√’·≈–§«“¡‡∑à“‡∑’¬¡°—π∑“ß‡æ» ‡ªÑ“À¡“¬∑’Ë ’Ë: ≈¥Õ—μ√“°“√쓬¢Õ߇¥Á°
‡ªÑ“À¡“¬∑’ËÀâ“: æ—≤π“ ÿ¢¿“æ μ√’¡’§√√¿å ‡ªÑ“À¡“¬∑’ËÀ°: μàÕ Ÿâ‚√§‡Õ¥ å ¡“‡≈‡√’¬ ·≈–‚√§ ”§—≠Õ◊Ëπ Ê ‡ªÑ“À¡“¬∑’ˇ®Á¥: √—°…“·≈–®—¥°“√ ‘Ëß·«¥≈âÕ¡Õ¬à“߬—Ëß
¬◊π ‡ªÑ“À¡“¬∑’Ë·ª¥: à߇ √‘¡°“√‡ªìπÀÿâπ à«π‡æ◊ËÕ°“√æ—≤π“„πª√–™“§¡‚≈°
Õ—μ√“쓬∑“√° Ÿß°«à“ 30 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬
·≈–Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï Ÿß°«à“ 40 μàÕ°“√
‡°‘¥¡’™’æ 1,000 √“¬(1) ¥—ßπ—Èπ°“√‡√àߥ”‡π‘π°“√μà“ß Ê
‡æ◊ËÕ≈¥Õ—μ√“쓬‡¥Á°„À⇪ìπ‰ªμ“¡‡ªÑ“À¡“¬®÷߇ªìπæ—π∏-
°‘®∑’Ë ”§—≠∑’Ë∑ÿ°ª√–‡∑»®–μâÕß∫√√≈ÿ¿“¬„π æ.». 2558(2) ª√–‡∑»‰∑¬°Á‡™àπ°—𠉥â„À⧔¡—Ëπ«à“®–¥”‡π‘π°“√
‡æ◊ËÕ∫√√≈ÿ‡ªÑ“À¡“¬°“√æ—≤π“·Ààß À— «√√…¿“¬„π æ.».
2558 Õ¬à“߉√°Áμ“¡ ¡’À≈“¬‡ªÑ“À¡“¬∑’˪√–‡∑»‰∑¬‰¥â
∫√√≈ÿ·≈â«À√◊Õ°”≈—ß°â“« Ÿà§«“¡ ”‡√Á®°àÕπ æ.». 2558 ´÷Ëß
√«¡∂÷߇ªÑ“À¡“¬∑’Ë ’Ë ç≈¥Õ—μ√“°“√쓬¢Õ߇¥Á°é ®÷߉¥â¡’
°“√°”Àπ¥ 燪ѓÀ¡“¬°“√æ—≤π“·Ààß À— «√√…©∫—∫
‡æ‘Ë¡‡μ‘¡é (Millennium Development Goals Plus - MDG+) ¢÷Èπ ´÷Ë߇ªìπ¿“√°‘®∑’ˬ“°¢÷Èπ°«à“‡¥‘¡ ”À√—∫
‡ªÑ“À¡“¬°“√≈¥Õ—μ√“쓬¢Õ߇¥Á°π—Èπ „π MDG+ ‰¥â
°”À𥉫â«à“®–≈¥Õ—μ√“쓬∑“√°„Àâ‡À≈◊Õ 15 μàÕ°“√
‡°‘¥¡’™’æ 1,000 √“¬ ¿“¬„π æ.». 2549 (¢≥–π’È ‰¥â
∫√√≈ÿ‡ªÑ“À¡“¬·≈⫇™àπ°—π) ·≈–≈¥Õ—μ√“쓬‡¥Á°Õ“¬ÿ μË”°«à“ 5 ªï∑’ËÕ“»—¬Õ¬Ÿà„π∫√‘‡«≥∑’Ë√“∫ Ÿß®—ßÀ«—¥∑“ß
¿“§‡Àπ◊Õ∫“ß®—ßÀ«—¥ ·≈– 3 ®—ßÀ«—¥„π¿“§„μâ ¿“¬„π æ.». 2558 ‚¥¬‰¡à‰¥â√–∫ÿ‡°≥±å‡ªÑ“À¡“¬‰«â«à“‡ªìπ‡∑à“‰√
μ“¡ MDG+ ∑’Ë°≈à“«¡“¢â“ßμâπ ®–‡ÀÁπ«à“®”‡ªìπ μâÕß¡’°“√μ‘¥μ“¡¿“«–°“√쓬¢Õ߇¥Á°„π√–¥—∫®—ßÀ«—¥
‰¡à„™à∑”‡©æ“–„π¿“æ√«¡¢Õߪ√–‡∑»‡∑à“π—Èπ °≈à“«§◊Õ
·μà≈–®—ßÀ«—¥‰¥â∑”π—Èπ°Á§◊Õ μ‘¥μ“¡®“°¢âÕ¡Ÿ≈°“√쓬
μ“¡∑–‡∫’¬π√“…Æ√ À√◊Õ ¢âÕ¡Ÿ≈°“√쓬¢Õß∑“√°∑’Ë¡“
√—∫∫√‘°“√∑’Ë ∂“π欓∫“≈¢Õß°√–∑√«ß “∏“√≥ ÿ¢
¿“¬„μâ 炧√ß°“√≈Ÿ°‡°‘¥√Õ¥ ·¡àª≈Õ¥¿—¬é (Safe Moth- erhood Project) ¢Õß°√¡Õπ“¡—¬ ‚¥¬ ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥ √«∫√«¡¢âÕ¡Ÿ≈®“° ∂“π欓∫“≈
·μà≈–‡¥◊Õπ ‡æ◊ËÕμ‘¥μ“¡¿“«–¥—ß°≈à“« ·≈– àß à«πÀπ÷Ëß
‰ª¬—ß à«π°≈“ß Õ¬à“߉√°Áμ“¡¢âÕ¡Ÿ≈°“√쓬¢Õß∑“√°
·≈–‡¥Á°®“°∑—Èß∑–‡∫’¬π√“…Æ√ ·≈– 炧√ß°“√≈Ÿ°‡°‘¥
√Õ¥ ·¡àª≈Õ¥¿—¬é ¬—ßμË”°«à“®√‘ß ‡π◊ËÕß®“°°“√®¥
∑–‡∫’¬π쓬¬—ßμ°À≈àπ ·≈– ”À√—∫√“¬ß“π®“° 炧√ß
°“√≈Ÿ°‡°‘¥√Õ¥ ·¡àª≈Õ¥¿—¬é °Á§√Õ∫§≈ÿ¡‡©æ“– ∂“π
欓∫“≈„π —ß°—¥°√–∑√«ß “∏“√≥ ÿ¢ ·≈–‡ªìπ¢âÕ¡Ÿ≈
‡©æ“–ºŸâ∑’Ë¡“√—∫∫√‘°“√‡∑à“π—Èπ ¥—ßπ—Èπ°“√ª√–‡¡‘π°“√
쓬¢Õ߇¥Á°„π√–¥—∫®—ßÀ«—¥®÷߇ªìπ‡√◊ËÕß∑â“∑“¬ ”À√—∫
∑ÿ°ΩÉ“¬∑’ˇ°’ˬ«¢âÕß
‡ æ◊Ë Õ μ‘ ¥ μ “ ¡ ∂ “ π ° “ √ ≥å ¢ Õ ß ‡ ¥Á ° · ≈ – μ √’ „π
¿Ÿ¡‘¿“§μà“ß Ê ∑—Ë«‚≈° Õߧ尓√¬Ÿπ‘‡´ø‰¥âæ—≤π“«‘∏’°“√
”√«®§√—«‡√◊Õπ‡æ◊ËÕ‡°Á∫¢âÕ¡Ÿ≈ ∂“π°“√≥凥Á°·≈– μ√’
∑’ˇ√’¬°«à“ ç°“√ ”√«®æÀÿ¥—™π’·∫∫°≈ÿà¡é (Multiple In- dicator Cluster Survey: MICS) °“√ ”√«®π’È ‰¥â
¥”‡π‘π°“√§√—Èß·√°„π æ.». 2538 „πª√–‡∑»μà“ß Ê ¡“°
°«à“ 60 ª√–‡∑» °“√ ”√«®§√—Èß∑’Ë Õß∑”¢÷Èπ„π æ.».
2543 „π 65 ª√–‡∑» ·≈–°“√ ”√«®≈à“ ÿ¥§√—Èß∑’Ë 3
¥”‡π‘π°“√‡¡◊ËÕ æ.». 2548 - 2549 §√Õ∫§≈ÿ¡ª√–‡∑»
μà“ß Ê °«à“ 50 ª√–‡∑» √«¡∑—Èߪ√–‡∑»‰∑¬ º≈°“√
”√«®·μà≈–§√—Èß‚¥¬‡©æ“–§√—Èß∑’Ë Õß·≈– “¡π—Èπ ¬Ÿπ‘‡´ø
‰¥â„™â‡ªìπ‡§√◊ËÕß¡◊Õ°“√μ‘¥μ“¡‡æ◊ËÕ∫√√≈ÿ‡ªÑ“À¡“¬·Ààß
°“√æ—≤π“ À— «√√…¥â«¬
”À√—∫°“√ ”√«® MICS3 „πª√–‡∑»‰∑¬ ¥”‡π‘π
°“√‚¥¬ ”π—°ß“π ∂‘μ‘·Ààß™“μ‘¿“¬„μâ°“√ π—∫ πÿπß∫
ª√–¡“≥®“°Õߧ尓√¬Ÿπ‘‡´øª√–‡∑»‰∑¬ πÕ°‡Àπ◊Õ
®“°°“√ ÿà¡μ—«Õ¬à“ߧ√—«‡√◊Õπ‡æ◊ËÕ‡ªìπμ—«·∑π√–¥—∫
ª√–‡∑»·≈–¿“§·≈â«π—Èπ °“√ ”√«®π’Ȭ—ß¡’‡ªÑ“À¡“¬∂÷ß
√–¥—∫®—ßÀ«—¥ ®÷߉¥â ÿà¡μ—«Õ¬à“߇æ‘Ë¡‡μ‘¡‡æ◊ËÕ “¡“√∂‡ªìπ μ—«·∑π√–¥—∫®—ßÀ«—¥ ®—ßÀ«—¥∑’Ë»÷°…“¡’∑—Èß ‘Èπ 26 ®—ßÀ«—¥**
°√–®“¬§√Õ∫§≈ÿ¡æ◊Èπ∑’Ë∑’Ë¡’≈—°…≥–摇»…μà“ß Ê ‡™àπ æ◊Èπ∑’Ë
∑’˪√– ∫¿—¬ ÷π“¡‘ æ◊Èπ∑’Ë 3 ®—ßÀ«—¥™“¬·¥π¿“§„μâ æ◊Èπ∑’Ë
∑’Ë¡’™“«‡¢“À√◊Õ™π°≈ÿà¡πâÕ¬ ‡ªìπμâπ ·¡â«à“®– “¡“√∂
μ‘¥μ“¡ ∂“π°“√≥凥Á°„π√–¥—∫®—ßÀ«—¥®“°°“√ ”√«®π’È
‰¥â ·μàÕ¬à“߉√°Áμ“¡ ¬—߉¡à¡’°“√√“¬ß“π¿“«–°“√쓬
¢Õ߇¥Á°„π√–¥—∫®—ßÀ«—¥‰«â‡≈¬ ¥—ßπ—Èπ °“√»÷°…“π’È®÷ß μâÕß°“√ª√–‡¡‘π ∂“π°“√≥å°“√쓬‡¥Á°„π√–¥—∫®—ßÀ«—¥
**®—ßÀ«—¥∑—Èß 26 ®—ßÀ«—¥ §◊Õ °√ÿ߇∑æ¡À“π§√ √–¬Õß √–·°â« √“™∫ÿ√’
°“≠®π∫ÿ√’ ‡™’¬ß„À¡à πà“π æ–‡¬“ ‡™’¬ß√“¬ ·¡àŒàÕß Õπ μ“° »√’ –‡°…
Õÿ∫≈√“™∏“π’ ¢Õπ·°àπ π§√æπ¡ ¡ÿ°¥“À“√ °√–∫’Ë æ—ßß“ ¿Ÿ‡°Áμ √–πÕß ß¢≈“ μŸ≈ μ√—ß ªíμμ“π’ ¬–≈“ ·≈– π√“∏‘«“
Journal of Health Science 2009 Vol. 18 No. 6
818
‡ª√’¬∫‡∑’¬∫§«“¡·μ°μà“ß ·≈–À“ªí®®—¬‡∫◊ÈÕßμâπ∑’Ë —¡æ—π∏å°—∫°“√쓬
«‘∏’°“√»÷°…“
°“√»÷°…“π’È„™â¢âÕ¡Ÿ≈®“° 2 ·À≈àߥ⫬°—π ·À≈àß
·√°‡ªìπ¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥凥Á°„πª√–‡∑»‰∑¬
æ.». 2548 - 2549 ´÷Ëß ”π—°ß“π ∂‘μ‘·Ààß™“쑇ªìπ Àπ૬ߓπ∑’Ë¥”‡π‘π°“√®—¥‡°Á∫‚¥¬„™â·∫∫ ”√«®æÀÿ
¥—™π’·∫∫°≈ÿà¡ (Multiple Indicator Cluster Survey:
MICS) ‡ªìπ‡§√◊ËÕß¡◊Õ ¿“¬„μâ°“√ π—∫ πÿπß∫ª√–¡“≥
®“°Õߧ尓√¬Ÿπ‘‡´øª√–‡∑»‰∑¬ °“√ ÿà¡μ—«Õ¬à“ߢÕß ”π—°ß“π ∂‘μ‘·Ààß™“μ‘„π√–¥—∫®—ßÀ«—¥·∫∫·∫àß™—Èπ 2 ¢—Èπ μÕπ (Stratified two stage) Àπà«¬μ—«Õ¬à“ߢ—Èπ·√°
§◊ Õ ™ÿ ¡ √ÿ ¡ Õ “ § “ √ ” À √— ∫ æ◊È π ∑’Ë „π‡¢μ‡∑»∫“≈ ·≈–
À¡Ÿà∫â“π ”À√—∫πÕ°‡¢μ‡∑»∫“≈ ®—ßÀ«—¥≈– 36 ™ÿ¡√ÿ¡
Õ“§“√/À¡Ÿà∫â“πμ—«Õ¬à“ß ¬°‡«âπ °√ÿ߇∑æ¡À“π§√ ∑’Ë Àπà«¬μ—«Õ¬à“ߢ—Èπ·√°¡’®”π«π∑—Èß ‘Èπ 156 ™ÿ¡√ÿ¡Õ“§“√
à«πÀπà«¬μ—«Õ¬à“ߢ—Èπ∑’Ë 2 §◊Õ §√—«‡√◊Õπ à«π∫ÿ§§≈ ∑”°“√
ÿࡇ≈◊Õ°¡“ 30 §√—«‡√◊Õπ®“°·μà≈–™ÿ¡√ÿ¡Õ“§“√/À¡Ÿà∫â“π μ—«Õ¬à“ß ∑”„Àâ ‰¥â§√—«‡√◊Õπμ—«Õ¬à“ß 1,080 §√—«‡√◊Õπ ”À√—∫·μà≈–®—ßÀ«—¥ ¬°‡«âπ°√ÿ߇∑æ´÷Ë߉¥â§√—«‡√◊Õπ μ—«Õ¬à“ß 4,680 §√—«‡√◊Õπ(3) (¥Ÿ√“¬≈–‡Õ’¬¥„π¿“§ºπ«°) ”À√—∫·À≈àߢâÕ¡Ÿ≈∑’Ë Õߧ◊Õ¢âÕ¡Ÿ≈μ—«Õ¬à“ß√âÕ¬≈– 20 ¢Õß ”¡–‚πª√–™“°√·≈–‡§À– æ.». 2543 ´÷Ëßμ—«Õ¬à“ß
√âÕ¬≈– 20 π’È ®–„Àâ¢âÕ¡Ÿ≈∫“߇√◊ËÕ߇æ‘Ë¡‡μ‘¡®“°¢âÕ¡Ÿ≈
æ◊Èπ∞“πª√–™“°√∑’Ë√«∫√«¡®“°∑ÿ°§√—«‡√◊Õπ ¢âÕ¡Ÿ≈®“°
∑—Èß Õß·À≈àß∑’Ëπ”¡“„™âπ’ȇªìπ¢âÕ¡Ÿ≈®”π«π μ√’«—¬‡®√‘≠
æ—π∏ÿå®”·π°μ“¡°≈ÿà¡Õ“¬ÿ ®”π«π∫ÿμ√‡°‘¥√Õ¥·≈–
®”π«π∫ÿμ√∑’ˇ ’¬™’«‘μ®”·π°μ“¡°≈ÿà¡Õ“¬ÿ¢Õß μ√’«—¬
‡®√‘≠æ—π∏ÿåπ—Èπ Ê ‡æ◊ËÕª√–¡“≥§à“Õ—μ√“쓬‡¥Á°¥â«¬
‡∑§π‘§«‘∏’∑“ßÕâÕ¡“
°“√»÷°…“§√—Èßπ’È„™â‡∑§π‘§«‘∏’ ç°“√ª√–¡“≥Õ—μ√“
쓬‡¥Á°∑“ßÕâÕ¡¥â«¬«‘∏’¢Õß∫√“ åé ∑’˪√—∫‚¥¬∑√— ‡´≈≈å (Trussell version of the original Brass indirect method)(4) ”À√—∫«‘∏’°“√∑’Ë∫√“ åæ—≤π“¢÷Èππ—Èπ
‡ªìπ°“√·ª≈ß§à“ —¥ à«π¢Õ߇¥Á°∑’ˇ ’¬™’«‘μ®“°®”π«π
∫ÿμ√‡°‘¥√Õ¥∑’Ë√“¬ß“πμ“¡°≈ÿà¡Õ“¬ÿ μ√’«—¬‡®√‘≠æ—π∏ÿå (15 - 19 20 - 24... 45 - 49 ªï) „À⇪ìπ‚Õ°“ ¢Õß°“√쓬
(probability of dying) ¢Õ߇¥Á°°àÕπ§√∫Õ“¬ÿμà“ß Ê Ÿμ√æ◊Èπ∞“π∑’Ë∫√“ å‡ πÕ‰«â§◊Õ
q(x) = k(i) D(i)
‡¡◊ËÕ q(x) §◊Õ ‚Õ°“ ¢Õß°“√쓬√–À«à“߇¡◊Ë Õ
·√°‡°‘¥∂÷ßÕ“¬ÿ‡μÁ¡ x ªï
D(i) §◊Õ —¥ à«π¢Õ߇¥Á°∑’ˇ ’¬™’«‘μ®“°
®”π«π∫ÿμ√‡°‘¥√Õ¥∑—ÈßÀ¡¥¢Õß μ√’
°≈ÿà¡Õ“¬ÿ i (i = 1-7)
k(i) §◊Õ §à“∑’Ëπ”¡“ª√—∫ —¥ à«π¢Õ߇¥Á°∑’Ë
‡ ’¬™’«‘μÕ—π‡π◊ËÕß¡“®“°ªí®®—¬∑’Ë ‰¡à
‡°’ˬ«¢âÕß°—∫°“√쓬
‡æ◊ËÕ “¡“√∂§”π«≥μ“¡ Ÿμ√¢â“ßμâπ ¢âÕ¡Ÿ≈∑’Ë
®”‡ªìπ§◊Õ 1) ®”π«π μ√’«—¬‡®√‘≠æ—π∏ÿå (Õ“¬ÿ 15 - 49 ªï) ®”·π°μ“¡°≈ÿà¡Õ“¬ÿ 5 ªï 2) ®”π«π∫ÿμ√‡°‘¥√Õ¥
®”·π°μ“¡°≈ÿà¡Õ“¬ÿ μ√’«—¬‡®√‘≠æ—π∏ÿå ·≈– 3) ®”π«π
∫ÿμ√‡°‘¥√Õ¥∑’ˇ ’¬™’«‘μ®”·π°μ“¡°≈ÿà¡Õ“¬ÿ μ√’«—¬
‡®√‘≠æ—π∏ÿå ·≈–§à“∑’˪√–¡“≥‰¥â®÷߇ªìπ§à“¢âÕ¡Ÿ≈√«¡ (ag- gregate data)
∫ √ “ å æ ∫ «à “ §à “ ∑’Ë π” ¡ “ ª √— ∫ π—È π ‡ °’Ë ¬ « ¢â Õ ß °— ∫
·∫∫·ºπ¿“«–‡®√‘≠æ—π∏ÿå ‡æ√“–·∫∫·ºπ¿“«–‡®√‘≠
æ—π∏ÿå®–‡ªìπμ—«°”Àπ¥°“√°√–®“¬¢Õß®”π«π‡¥Á°„π
·μà≈–°≈ÿà¡Õ“¬ÿ¢Õß μ√’μ“¡√–¬–‡«≈“∑’ˇº™‘≠°—∫§«“¡
‡ ’ˬßμàÕ°“√쓬π—Èπ Ê Õ¬à“߉√°Áμ“¡ ¡°“√¢Õß∫√“ å
„™â ‰¥â¥’°—∫°√≥’∑’Ë¿“«–‡®√‘≠æ—π∏ÿå¢Õß μ√’·≈–¿“«–°“√
쓬‰¡à‡ª≈’ˬπ·ª≈ß ¥—ßπ—Èπ ®÷߉¥â欓¬“¡ª√—∫·°â§à“ k(i)
‡æ◊ËÕ –∑âÕπ°“√ª√–¡“≥‡¡◊ËÕ¿“«–‡®√‘≠æ—π∏ÿå·≈–°“√
쓬‡ª≈’ˬπ·ª≈ß ·≈–§à“ k(i) ∑’˪√—∫‚¥¬∑√— ‡´≈≈å ‡¡◊ËÕ π”¡“ª√–¡“≥ q(x) ®–„Àâ§à“∑’Ë Õ¥§≈âÕß°—∫‡«≈“ t(x) ªï °àÕπ°“√ ”√«® ·≈–‡«≈“ t(x) π’È®–‰¡à‡ª≈’ˬπ·ª≈ß
‰ªμ“¡Õ—μ√“°“√‡ª≈’ˬπ·ª≈ߢÕßÕ—μ√“쓬 (μ√“∫„¥∑’Ë Õ—μ√“°“√‡ª≈’ˬπ·ª≈ߧß∑’Ë)
§à“ª√–¡“≥Õ—μ√“쓬‡¥Á°∑’Ë ‰¥â®“°‡∑§π‘§«‘∏’π’È
Õ¥§≈âÕß°—∫°≈ÿà¡Õ“¬ÿ¢Õß μ√’ π—Ëπ§◊Õ §à“ª√–¡“≥®“°
μ√’°≈ÿà¡Õ“¬ÿ 15 - 19, 20 - 24, 25 - 29, 30 - 34, 35 - 39, 40 - 44 ·≈– 45 - 49 ªï „Àâ§à“‚Õ°“ ¢Õß°“√
쓬μ—Èß·μà‡¡◊ËÕ·√°‡°‘¥®π∂÷ßÕ“¬ÿ 1 2 3 5 10 15 ·≈–
20 ªï‡μÁ¡ μ“¡≈”¥—∫ ·≈–·∑π¥â«¬ q(1), q(2), q(3), q(5), q(10), q(15) ·≈– q(20) ®“°§à“ª√–¡“≥∑—Èß 7 π’È
§à“ q(5) À√◊Õ∑’ˇ√’¬°°—π∑—Ë«‰ª«à“ çÕ—μ√“쓬‡¥Á°Õ“¬ÿ μË”°«à“ 5 ªïé (Under-five mortality rate: U5MR) “¡“√∂„™â‡ªìπμ—«™’È«—¥¿“«–°“√쓬„π‡¥Á°∑’Ë¥’‡π◊ËÕß®“°
¢âÕ¡Ÿ≈∑’ˉ¥â®“° μ√’°≈ÿà¡Õ“¬ÿπ’È (30-34 ªï) ¡’§«“¡§≈“¥
‡§≈◊ËÕππâÕ¬∑’Ë ÿ¥‡¡◊ËÕ‡∑’¬∫°—∫ μ√’°≈ÿà¡Õ“¬ÿÕ◊Ëπ Ê(5) ·μà
§à“ª√–¡“≥π’È –∑âÕπÕ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï‡¡◊ËÕ ª√–¡“≥ 5-7 ªï°àÕπ°“√ ”√«®
°“√ª√–¡“≥Õ—μ√“쓬‡¥Á°μ“¡«‘∏’∑’Ë°≈à“«¡“¢â“ß μâππ’È ®–ª√–¡“≥®“°¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥凥Á°
„πª√–‡∑»‰∑¬ æ.». 2548 - 2549 √–¥—∫®—ßÀ«—¥ 26
®—ßÀ«—¥ ‡π◊ËÕß®“°¢âÕ¡Ÿ≈¥—ß°≈à“«¡“®“°μ—«Õ¬à“ß §à“
ª√–¡“≥∑’ˉ¥â¬àÕ¡¡’§«“¡§≈“¥‡§≈◊ËÕπÕ—π‡π◊ËÕß¡“®“°
°“√ ÿà¡μ—«Õ¬à“ß ¥—ßπ—Èπ®÷ß¡’°“√𔇠πÕ§à“§«“¡§≈“¥
‡§≈◊ËÕπ¡“μ√∞“π (standard error) ‚¥¬„™â«‘∏’ª√–¡“≥
§«“¡·ª√ª√«πÕ¬à“ßßà“¬∑’ˇ πÕ‚¥¬‡¡π‚¥´“·≈–
§“≈ ∫’°(6) §«∫§Ÿà°—∫§à“Õ—μ√“쓬‡¥Á°∑’˪√–¡“≥‰¥â
‡¡◊ËÕª√–¡“≥Õ—μ√“쓬‡¥Á°„π 26 ®—ßÀ«—¥®“°
¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥凥Á°„πª√–‡∑»‰∑¬ æ.».
2548 - 2549 ·≈â«π—Èπ ‡æ◊ËÕ»÷°…“«à“ªí®®—¬Õ–‰√∫â“ß∑’Ë¡’
§«“¡ —¡æ—π∏å°—∫Õ—μ√“쓬‡À≈à“π’È ®÷ßπ”·π«§‘¥¢Õß
‚¡ ‡≈¬å·≈–‡™Áπ(7) ∑’Ë°≈à“««à“μ—«°”Àπ¥¥â“π‡»√…∞°‘®
—ߧ¡¡’º≈μàÕ°“√쓬¢Õ߇¥Á°‚¥¬°√–∑”ºà“πμ—«°”Àπ¥
„°≈♑¥ 5 °≈ÿࡉ¥â·°à ªí®®—¬¥â“π¡“√¥“ °“√ªπ‡ªóôÕπ
¥â“π ‘Ëß·«¥≈âÕ¡ °“√¢“¥ “√Õ“À“√ °“√∫“¥‡®Á∫ ·≈–
°“√§«∫§ÿ¡§«“¡‡®Á∫ªÉ«¬/¡“μ√°“√°“√ªÑÕß°—π à«π
∫ÿ§§≈ ¡“‡ªìπ°√Õ∫„π°“√∑¥ Õ∫§«“¡ —¡æ—π∏å ´÷Ëß ªí®®—¬‡À≈à“π’ÈμâÕ߇ªìπªí®®—¬„π√–¥—∫®—ßÀ«—¥‡¡◊ËÕª√–¡“≥
5-7 ªï°àÕπ°“√ ”√«®‡™àπ°—π‡æ◊ËÕ„Àâ Õ¥§≈âÕß°—∫Õ—μ√“
쓬‡¥Á°∑’˪√–¡“≥‰¥â ®÷ß∑”„Àâμ—«·ª√∑’Ëπ”¡“„™â ‰¥â¡’
§àÕπ¢â“ß®”°—¥ „π∑’Ëπ’È„™â‡æ’¬ß√âÕ¬≈–¢Õß§π¬“°®π¥â“π
√“¬®à“¬‡¡◊ËÕªï æ.». 2543 ·≈–√“¬‰¥â‡©≈’ˬμàÕÀ—«‡¡◊ËÕªï æ.». 2543 ‡ªìπμ—«·ª√¥â“π‡»√…∞°‘® ¢âÕ¡Ÿ≈∑—Èß Õ߉¥â
¡“®“°√“¬ß“π¢Õß ”π—°ß“π§≥–°√√¡°“√æ—≤π“°“√
‡ » √ … ∞ °‘ ® · ≈ – — ß § ¡ · Àà ß ™ “ μ‘( 8 , 9 ) √â Õ ¬ ≈ – § « “ ¡
§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π „™â‡ªìπμ—«·ª√ªí®®—¬¥â“π
°“√§«∫§ÿ¡§«“¡‡®Á∫ªÉ«¬/¡“μ√°“√ªÑÕß°—π à«π∫ÿ§§≈
μ—«·ª√π’ȧ«√‡ªìπ¢âÕ¡Ÿ≈√“¬®—ßÀ«—¥‡¡◊ËÕªï 2543 ·μà
‡π◊ËÕß®“°¢âÕ¡Ÿ≈√âÕ¬≈–§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫
«—§´’π∑’Ë¡’Õ¬Ÿà‡ªìπ¢âÕ¡Ÿ≈®“°°“√ ”√«®„π®—ßÀ«—¥μ—«Õ¬à“ß
∑’ˉ¡à Õ¥§≈âÕß°—∫®—ßÀ«—¥„π°“√»÷°…“π’È ¥—ßπ—Èπ°“√»÷°…“π’È
®÷ß„™â√âÕ¬≈–§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π®“°
¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥凥Á°„πª√–‡∑»‰∑¬ æ.».
2 5 4 8 - 2 5 4 9 ‚ ¥ ¬ ¡’ ¢â Õ ¡ ¡ÿ μ‘ «à “ √â Õ ¬ ≈ – § « “ ¡
§√Õ∫§≈ÿ¡‡¡◊ËÕªï æ.». 2543 ‰¡à·μ°μà“ß®“°‡¡◊ËÕªï æ.».
2548 - 2549 ¡“°π—° ‡æ√“–°√¡§«∫§ÿ¡‚√§√“¬ß“π«à“
§ « “ ¡ § √ Õ ∫ § ≈ÿ ¡ ¢ Õ ß ° “ √ ‰ ¥â √— ∫ «— § ´’ π Õ ¬Ÿà „ π ‡ ° ≥ ±å ¡Ë”‡ ¡Õ¡“μ—Èß·μà æ.». 2535 ·≈–°“√¥”‡π‘πß“π‰¡à¡’
§«“¡‡ª≈’ˬπ·ª≈ß¡“°π—°(10-12) ·≈–„™â√âÕ¬≈–¢Õß μ√’
Õ“¬ÿ 15-49 ªï∑’Ë¡’°“√»÷°…“√–¥—∫¡—∏¬¡À√◊Õ Ÿß°«à“‡ªìπ μ—«·ª√ ∂“π¿“æ —ß§¡´÷Ë߇ªìπªí®®—¬¥â“π¡“√¥“ μ—«·ª√
π’ȉ¥â¡“®“°°“√§”π«≥¢âÕ¡Ÿ≈ ”¡–‚πª√–™“°√·≈–‡§À–
æ.». 2543 π”μ—«·ª√‡À≈à“π’È∑¥ Õ∫§«“¡ —¡æ—π∏å°—∫
Õ—μ√“쓬‡¥Á°¥â«¬°“√«‘‡§√“–Àå∂¥∂Õ¬æÀÿ·∫∫∑’≈–¢—Èπ (stepwise multiple regression)
º≈°“√»÷°…“
®“°¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥凥Á°„πª√–‡∑»‰∑¬
æ.». 2548 - 2549 π—Èπ æ∫«à“ Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“
5 ªï∑’˪√–¡“≥‰¥â‚¥¬«‘∏’∑“ßÕâÕ¡ –∑âÕπ°“√쓬‡¡◊ËÕ ª√–¡“≥ 6 ªï‚¥¬‡©≈’ˬ°àÕπ°“√ ”√«® (√–À«à“ß æ.».
2540 - 2544) Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï¡’§«“¡
º—π·ª√„π·μà≈–®—ßÀ«—¥ °≈à“«§◊Õ ‡¡◊ËÕμ—¥®—ßÀ«—¥ ߢ≈“
·≈–¿Ÿ‡°ÁμÕÕ°‰ª ‡π◊ËÕß®“°§à“∑’˪√–¡“≥‰¥â‡∑à“°—∫ 0
‡æ√“–‰¡à¡’√“¬ß“π®”π«π∫ÿμ√∑’ˇ ’¬™’«‘μ®“° μ√’Õ“¬ÿ 30
Journal of Health Science 2009 Vol. 18 No. 6
820
- 34 ªï‡≈¬ ®—ßÀ«—¥√“™∫ÿ√’¡’Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï μË”∑’Ë ÿ¥ §◊Õ 4.8 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬ „π
¢≥–∑’Ë®—ßÀ«—¥π√“∏‘«“ ¡’Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï Ÿß ÿ¥ §◊Õ 37.1 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬
‡¡◊ËÕ®—¥°≈ÿà¡Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªïÕÕ°‡ªìπ
™à«ß <10, 10 - 19.9, 20 - 29.9 ·≈– 30 ¢÷Èπ‰ª μàÕ
°“√‡°‘¥μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬ æ∫«à“ ¡’Õ¬Ÿà 7 ®—ßÀ«—¥
§◊Õ √“™∫ÿ√’ »√’ –‡°… ‡™’¬ß„À¡à π§√æπ¡ °“≠®π∫ÿ√’
√–·°â« ·≈–·¡àŒàÕß Õπ ∑’ËÕ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï μË”°«à“ 10 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬ „π¢≥–∑’Ë 10
μ“√“ß∑’Ë 1 Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï √“¬®—ßÀ«—¥ ª√–¡“≥®“°¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥凥Á°œ „πª√–‡∑»‰∑¬ æ.». 2548-2549
®”π«π μ√’ ®”π«π Õ—μ√“쓬‡¥Á° ªï∑’Ë ™à«ß§«“¡‡™◊ËÕ¡—Ëπ√âÕ¬≈– 95
®—ßÀ«—¥ 15 - 49 ªï ∫ÿμ√‡°‘¥√Õ¥ Õ“¬ÿμË”°«à“ 5 ªï (q5) Õâ“ßÕ‘ß ¢ÕßÕ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï
∑—ÈßÀ¡¥ ∑—ÈßÀ¡¥ μàÕ 1,000 °“√‡°‘¥¡’™’æ μË” ÿ¥ Ÿß ÿ¥
√“™∫ÿ√’ 1,029 1,232 4.8 2540.9 4.1 5.5
»√’ –‡°… 739 1,122 5.5 2543.9 4.7 6.2
‡™’¬ß„À¡à 992 937 7.5 2543.1 6.3 8.8
π§√æπ¡ 754 1,056 8.1 2539.9 7.4 8.9
°“≠®π∫ÿ√’ 1,154 1,523 8.5 2542.7 7.7 9.2
√–·°â« 951 1,565 8.6 2541.2 7.8 9.4
·¡àŒàÕß Õπ 857 1,247 9.3 2542.5 8.4 10.2
μŸ≈ 806 1,396 10.2 2540 9.5 10.9
æ–‡¬“ 983 1,303 10.8 2540.3 9.7 12
°√ÿ߇∑æ 4,792 4,359 11.8 2542.5 11.5 12.1
æ—ßß“ 764 1,037 12.9 2536 11.8 14.1
‡™’¬ß√“¬ 886 1,139 13.0 2544.4 11.6 14.4
√–πÕß 833 1,138 13.3 2540.9 12.2 14.3
°√–∫’Ë 1,009 1,472 13.9 2542.4 13.1 14.7
Õÿ∫≈√“™∏“π’ 1,224 1,802 15.5 2542.9 14.7 16.2
¡ÿ°¥“À“√ 817 1,189 15.9 2542.8 14.6 17.2
√–¬Õß 1,113 1,322 17.4 2541.7 16.3 18.6
¬–≈“ 1,341 2,275 22.7 2542.6 22 23.3
ªíμμ“π’ 1,121 1,918 23.2 2541.8 22.3 24.1
¢Õπ·°àπ 1,035 1,299 26.6 2543.1 25.2 28
μ“° 802 1,108 27.2 2543.1 25 29.3
πà“π 753 1,329 28.7 2541.1 26.8 30.7
μ√—ß 1,111 1,597 29.1 2541 27.9 30.2
π√“∏‘«“ 607 1,071 37.1 2542.2 35.1 39.1
¿Ÿ‡°Áμ 893 948 * 2539.7
ߢ≈“ 985 1,377 * 2542.4
À¡“¬‡Àμÿ: * —¥ à«π°“√쓬¢Õ߇¥Á°μË”¡“° ∑”„Àâ§à“∑’˪√–¡“≥‰¥âμË”º‘¥ª°μ‘
®—ßÀ«—¥ ( μŸ≈ æ–‡¬“ °√ÿ߇∑æ æ—ßß“ ‡™’¬ß√“¬ √–πÕß
°√–∫’Ë Õÿ∫≈√“™∏“π’ ¡ÿ°¥“À“√ ·≈–√–¬Õß) ¡’Õ—μ√“
쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï ¡“°°«à“ 10 ·μàπâÕ¬°«à“ 20 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬ 1 ®—ßÀ«—¥„π¿“§μ–«—πÕÕ°
‡©’¬ß‡Àπ◊Õ (¢Õπ·°àπ) 2 ®—ßÀ«—¥∑“ß¿“§‡Àπ◊Õ (μ“°
·≈–πà“π) ·≈– 3 ®—ßÀ«—¥∑“ß¿“§„μâ (μ√—ß ¬–≈“ ·≈–
ªíμμ“π’) ¡’Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï ¡“°°«à“ 20
·μàπâÕ¬°«à“ 30 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬ ¡’‡æ’¬ß
®—ßÀ«—¥‡¥’¬« §◊Õ π√“∏‘«“ ∑’ËÕ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“
5 ªïπ—Èπ Ÿß°«à“ 30 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬ (μ“√“ß∑’Ë 1)
‡¡◊ËÕ∑”°“√∑¥ Õ∫ À —¡æ—π∏å√–À«à“ßÕ—μ√“쓬
‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï °—∫ªí®®—¬√–¥—∫®—ßÀ«—¥∑’ËÕ“®¡’
§«“¡ —¡æ—π∏凙‘߇ âπ°—∫Õ—μ√“쓬‡¥Á° 4 ªí®®—¬ §◊Õ
√âÕ¬≈–¢Õß§π¬“°®π¥â“π√“¬®à“¬ √“¬‰¥â‡©≈’ˬμàÕÀ—«
√âÕ¬≈–§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π ·≈–√âÕ¬≈–
¢Õß μ√’Õ“¬ÿ 15 - 49 ªï∑’Ë¡’°“√»÷°…“√–¥—∫¡—∏¬¡À√◊Õ Ÿß°«à“ æ∫«à“¡’‡æ’¬ßªí®®—¬‡¥’¬«∑’Ë¡’§«“¡ —¡æ—π∏凙‘ß
‡ âπÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘μ‘°—∫Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“
5 ªï §◊Õ§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π (r = -0.413, p<.05) À —¡æ—π∏å∑’Ëæ∫· ¥ß§«“¡ —¡æ—π∏凙‘ß≈∫ °≈à“«
§◊Õ ®—ßÀ«—¥∑’Ë¡’§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π¢Õß
‡¥Á° Ÿß®–¡’Õ—μ√“쓬‡¥Á°μË” (√Ÿª∑’Ë 1) ·≈–‡¡◊ËÕπ”ªí®®—¬
‡À≈à“π’È¡“«‘‡§√“–Àå∂¥∂Õ¬æÀÿ·∫∫∑’≈–¢—Èπ (stepwise multiple regression) æ∫«à“μ—«·ª√∑’˧߇À≈◊ÕÕ¬Ÿà„π ¡°“√∑”𓬧◊Õ§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π
√Ÿª∑’Ë 1 À —¡æ—π∏å√–À«à“ßÕ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï §«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π (Àπ૬) °—∫ °. ªí®®—¬¥â“𧫓¡¬“°®π
¢. √“¬‰¥â §. °“√‰¥â√—∫«—§´’π ·≈– ß. μ√’«—¬‡®√‘≠æ—π∏ÿå∑’Ë¡’°“√»÷°…“√–¥—∫¡—∏¬¡
Journal of Health Science 2009 Vol. 18 No. 6
822
‡∑à“π—Èπ ´÷Ëß “¡“√∂‡¢’¬π‡ªìπ ¡°“√∑”𓬥—ßπ’È
Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï = 45.09 - 0.36 (§«“¡
§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π) --- (1)
”À√—∫°“√‡ª≈’ˬπ·ª≈ߧ«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â
√—∫«—§´’πμ“¡ ¡°“√ (1) “¡“√∂Õ∏‘∫“¬°“√‡ª≈’ˬπ·ª≈ß
¢ÕßÕ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï ‰¥â√âÕ¬≈– 13.3 (μ“√“ß∑’Ë 2)
«‘®“√≥å
°“√»÷°…“¿“«–°“√쓬„π‡¥Á°π—Èπ ¡’¥—™π’∑’Ë„™â«—¥Õ¬Ÿà 2 μ—« §◊Õ Õ—μ√“쓬∑“√° ·≈–Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“
5 ªï ‚¥¬∑—Ë«‰ª¥—™π’∑—Èß Õß¡—°‰¥â¡“®“°¢âÕ¡Ÿ≈°“√쓬
¢Õß∑“√°·≈–‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï‚¥¬μ√ß ‡™àπ ®“°
°“√ ”√«®∑’Ë¡’§”∂“¡«à“¡’‡¥Á°‡À≈à“π’È쓬„π√Õ∫ªï°àÕπ
°“√ ”√«®À√◊Õ‰¡à À√◊Õ¢âÕ¡Ÿ≈®“°°“√®¥∑–‡∫’¬π쓬
πÕ°®“°¢âÕ¡Ÿ≈°“√쓬·≈â« ¬—ßμâÕß°“√¢âÕ¡Ÿ≈®”π«π
‡¥Á°‡°‘¥¡’™’æ„πªï‡¥’¬«°—ππ—Èπ
”À√—∫ª√–‡∑»‰∑¬π—Èπ ¡’°“√ ”√«®∑’Ë∂“¡°“√
쓬¢Õ߇¥Á°‚¥¬μ√ß §◊Õ °“√ ”√«®°“√‡ª≈’ˬπ·ª≈ß ª√–™“°√¢Õߪ√–‡∑»‰∑¬ (Survey of Population Change, SPC) °“√ ”√«®¥â“πª√–™“°√·≈– ÿ¢¿“æ (Thailand Demographic and Health Survey, TDHS)
·≈–°“√ ”√«®¿“«–‡®√‘≠æ—π∏ÿå (Survey of Fertility in Thailand ´÷Ë߇ªìπ à«πÀπ÷ËߢÕß World Fertility Survey, WFS) °“√ ”√«® 2 ª√–‡¿∑À≈—ߥ”‡π‘π°“√‡¡◊Ë Õ ª√–¡“≥°«à“ 20 ªï¡“·≈â« ®÷߉¡à∑—π ¡—¬ πÕ°®“°π—Èπ
¬—߉¡à “¡“√∂„ÀâÕ—μ√“쓬‡¥Á°„π√–¥—∫®—ßÀ«—¥‰¥â à«π
°“√ ”√«®°“√‡ª≈’ˬπ·ª≈ߪ√–™“°√¢Õߪ√–‡∑»‰∑¬
·¡â«à“®–¥”‡π‘π°“√∑ÿ° Ê 10 ªï °Áμ“¡ °“√ ”√«®π’È„Àâ Õ—μ√“쓬‡¥Á°„π√–¥—∫ª√–‡∑»·≈–¿“§‡∑à“π—Èπ ‰¡à “¡“√∂„ÀâÕ—μ√“쓬‡¥Á°„π√–¥—∫®—ßÀ«—¥‰¥â‡™àπ°—π
‡¡◊ËÕæ‘®“√≥“¢âÕ¡Ÿ≈®“°°“√®¥∑–‡∫’¬π쓬 ªí≠À“
∑’Ëæ∫§◊Õ¡’°“√μ°®¥∑–‡∫’¬π‚¥¬‡©æ“–„π∑“√° æ∫«à“¡’
°“√μ°®¥∑–‡∫’¬π Ÿß πÕ°®“°π—Èπ¬—ß¡’°“√μ°®¥
∑–‡∫’¬π‡°‘¥ ¢âÕ¡Ÿ≈®“°·À≈àßπ’È®÷ß„ÀâÕ—μ√“쓬∑“√°
·≈–Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªïμË”°«à“®√‘ß ·¡â«à“
¢âÕ¡Ÿ≈®“°°“√®¥∑–‡∫’¬π쓬®–¡’Õ¬Ÿà„π√–¥—∫®—ßÀ«—¥
¥â«¬°Áμ“¡ ªí≠À“∑’Ëæ∫„π√–¥—∫®—ßÀ«—¥∑’ËπÕ°‡Àπ◊Õ®“°
°“√μ°®¥∑–‡∫’¬π·≈â«°Á§◊Õ ªí≠À“‡√◊ËÕß°“√®¥∑–‡∫’¬π
‡°‘¥ ‡æ√“–°“√®¥∑–‡∫’¬π‡°‘¥®–®¥μ“¡ ∂“π∑’˧≈Õ¥
‰¡à„™àμ“¡∑’ËÕ¬Ÿà¢Õß¡“√¥“ ¥—ßπ—Èπ®”π«π‡¥Á°‡°‘¥¡’™’æ„π
®—ßÀ«—¥∑’Ë¡’‚√ß欓∫“≈¢π“¥„À≠à Ê μ—ÈßÕ¬Ÿà ‡™àπ °√ÿ߇∑æ
‡™’¬ß„À¡à ¢Õπ·°àπ Õÿ∫≈√“™∏“π’ °Á®–¡’®”π«π¡“°
‡°‘π®√‘ß ‡æ√“–¡’¡“√¥“®“°®—ßÀ«—¥μà“ß Ê ‡¢â“¡“§≈Õ¥
∫ÿμ√„π‚√ß欓∫“≈‡À≈à“π—Èπ ∑”„ÀâÕ—μ√“∑’ˉ¥âÕ“®μË”°«à“
®√‘ßÀ√◊Õ∫‘¥‡∫◊Õπ‰ª
¢âÕ®”°—¥μà“ß Ê ¥—ß°≈à“«¢â“ßμâπ ∑”„Àâ°“√»÷°…“
°“√쓬¢Õ߇¥Á°„π∑’Ëπ’È®”‡ªìπμâÕ߇≈◊Õ°«‘∏’°“√ª√–¡“≥
∑“ßÕâÕ¡®“°§”∂“¡®”π«π∫ÿμ√‡°‘¥√Õ¥∑—ÈßÀ¡¥ ·≈–
®”π«π∫ÿμ√∑’ˬ—ß¡’™’«‘μÕ¬Ÿà¢Õß μ√’«—¬‡®√‘≠æ—π∏ÿå ≥ ¢≥–
π’È¡’¢âÕ¡Ÿ≈®“° 2 ·À≈àߥ⫬°—π∑’Ë “¡“√∂π”¡“„™â ‰¥â §◊Õ ”¡–‚πª√–™“°√ ·≈–¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥å
‡¥Á°„πª√–‡∑»‰∑¬ æ.». 2548 - 2549 ´÷ËߢâÕ¡Ÿ≈®“°
·À≈àßÀ≈—ßπ—∫«à“‡ªìπ¢âÕ¡Ÿ≈∑’ˇªìπªí®®ÿ∫—π¡“°∑’Ë ÿ¥ ®÷ß∂Ÿ°
μ“√“ß∑’Ë 2 º≈°“√«‘‡§√“–Àå∂¥∂Õ¬Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï¥â«¬§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π
U5MR Coef. SE t P>|t| 95%CI
Vaccine coverage -0.3639 0.171 -2.13 0.045 -0.7185 - -0.0094
Constant 45.0946 13.815 3.26 0.004 16.4432 - 73.7461
Model fit; F1,22 = 4.53, p < 0.05, Adj. R2 = 0.1331
π”¡“„™â„π°“√»÷°…“§√—Èßπ’È
®“°¢âÕ¡Ÿ≈°“√ ”√«® ∂“π°“√≥凥Á°„πª√–‡∑»‰∑¬
æ.». 2548 - 2549 · ¥ß„Àâ‡ÀÁπ«à“¿“«–°“√쓬„π
‡¥Á°‡¡◊ËÕ· ¥ß¥â«¬Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï ¬—ߧß
¡’§«“¡·μ°μà“ß°—π§àÕπ¢â“ß¡“°„π√–¥—∫®—ßÀ«—¥ °≈à“«§◊Õ
¡’Õ¬Ÿà∂÷ß 7 ®—ßÀ«—¥∑’Ë®—¥«à“Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï μË”¡“° (μË”°«à“ 10 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬) ‰¥â·°à
√“™∫ÿ√’ »√’ –‡°… ‡™’¬ß„À¡à π§√æπ¡ °“≠®π∫ÿ√’
√–·°â« ·≈–·¡àŒàÕß Õπ „π¢≥–∑’ËÕ’° 7 ®—ßÀ«—¥®—¥
‡ªìπ®—ßÀ«—¥∑’ËÕ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªïÕ¬Ÿà„π√–¥—∫
Ÿß¡“° ( Ÿß°«à“ 20 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬) ‰¥â·°à
¬–≈“ ªíμμ“π’ ¢Õπ·°àπ μ“° πà“π μ√—ß ·≈–π√“∏‘«“
¥Ÿ‡À¡◊Õπ«à“Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï„πÀ≈“¬
®—ßÀ«—¥‰¡à Õ¥§≈âÕß°—∫√–¥—∫°“√æ—≤π“¢Õß®—ßÀ«—¥π—ÈπÊ
¥—߇™àπ ·¡àŒàÕß Õπ »√’ –‡°… ·≈– √–·°â« ‡ªìπ
®—ßÀ«—¥∑’Ë¡’√âÕ¬≈–§π¬“°®π¥â“π√“¬®à“¬ ≥ ªï 2543
‡∑à“°—∫ 46.6 40.7 ·≈– 37.0(8) Ÿß‡ªìπÕ—π¥—∫ 2 4 ·≈–
6 μ“¡≈”¥—∫‡¡◊ËÕ‡∑’¬∫°—∫∑ÿ°®—ßÀ«—¥μ—«Õ¬à“ß ·μà¡’Õ—μ√“
쓬‡¥Á° Ÿß‰¡à‡°‘π 10 μàÕ°“√‡°‘¥¡’™’æ 1,000 √“¬‡∑à“π—Èπ
„π∑“ßμ√ß°—π¢â“¡ ®—ßÀ«—¥μ√—ß´÷Ëß¡’√âÕ¬≈–§π¬“°®π
¥â“π√“¬®à“¬ ≥ ªï 2543 ‡∑à“°—∫ 7.2(8) ®—¥Õ¬Ÿà„πÕ—π¥—∫∑’Ë 19 ®“° 24 Õ—π¥—∫ (‰¡à√«¡¿Ÿ‡°Áμ ·≈– ߢ≈“) °≈—∫¡’
Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï Ÿß‡°◊Õ∫ 30 μàÕ°“√‡°‘¥
¡’™’æ 1,000 √“¬ ¥—ßπ—Èπ°“√‡≈◊Õ°μ—«·ª√‡æ◊ËÕÕ∏‘∫“¬
§«“¡·μ°μà“ߢÕßÕ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï Õ“®
μâÕßæ‘®“√≥“μ—«·ª√Õ◊Ëπ∑’Ë¡’§«“¡‡À¡“– ¡°«à“ ”À√—∫
μ—«·ª√∑“ߥâ“π‡»√…∞°‘®∑’Ë –∑âÕπ√–¥—∫°“√æ—≤π“‰¡à
«à“®–‡ªìπ√âÕ¬≈–§π¬“°®π¥â“π√“¬®à“¬ À√◊Õ √“¬‰¥â
‡©≈’ˬμàÕÀ—« ®—¥‡ªìπμ—«·ª√∑’ˉ¡à„°≈♑¥μàÕ°“√쓬¢Õß
‡¥Á°‡∑à“„¥π—°
‡¡◊ËÕπ”°√Õ∫·π«§‘¥ ”À√—∫«‘‡§√“–Àå°“√√Õ¥™’æ
¢Õ߇¥Á°„πª√–‡∑»°”≈—ßæ—≤π“¢Õß‚¡ ‡≈¬å·≈–‡™Áπ(7) ¡“
„™â‡ªìπ·π«∑“ß«‘‡§√“–À姫“¡ —¡æ—π∏å„π°“√»÷°…“π’È π—∫
‡ªìπ°“√π”°√Õ∫°“√«‘‡§√“–Àå√–¥—∫∫ÿ§§≈¡“ª√–¬ÿ°μå
‡æ◊ËÕ«‘‡§√“–Àå√–¥—∫®—ßÀ«—¥ ´÷Ëßæ∫«à“ μ—«·ª√‡√◊ËÕߧ«“¡
§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π ´÷Ëß®—¥‡ªìπ¡“μ√°“√°“√
ªÑÕß°—π à«π∫ÿ§§≈ ¡’§«“¡ —¡æ—π∏å„π∑“ß≈∫°—∫Õ—μ√“
쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï ·¡â«à“μ—«·ª√π’È “¡“√∂Õ∏‘∫“¬
°“√쓬¢Õ߇¥Á°‰¥â√âÕ¬≈– 13 °Áμ“¡
°“√»÷°…“π’È ‰¡àæ∫«à“√–¥—∫°“√»÷°…“¢Õß¡“√¥“¡’
§«“¡ —¡æ—π∏å°—∫°“√쓬¢Õ߇¥Á° Õ“®‡π◊ËÕß¡“®“°
—¥ à«π¢Õß μ√’∑’Ë¡’°“√»÷°…“√–¥—∫¡—∏¬¡À√◊Õ Ÿß°«à“„π
·μà≈–®—ßÀ«—¥¡’§«“¡º—π·ª√‰¡à¡“°π—° °√ÿ߇∑æœ ‡ªìπ
®—ßÀ«—¥μ—«Õ¬à“ß®—ßÀ«—¥‡¥’¬«∑’Ë√âÕ¬≈– μ√’∑’Ë¡’°“√»÷°…“
√–¥—∫¡—∏¬¡À√◊Õ Ÿß°«à“¡’§à“ Ÿß‡°◊Õ∫√âÕ¬≈– 70 „π¢≥–
∑’Ë®—ßÀ«—¥Õ◊ËπÊ §à“√âÕ¬≈–Õ¬Ÿà„π™à«ßª√–¡“≥√âÕ¬≈– 30 - 40 ‡∑à“π—Èπ (mean 35.7, SD 6.2) ®÷ßÕ“®°≈à“«‰¥â«à“
°√≥’¢Õߪ√–‡∑»‰∑¬ °“√»÷°…“¢Õß μ√’‰¡à„™àªí®®—¬∑’Ë¡’
§«“¡ —¡æ—π∏å°—∫°“√쓬¢Õ߇¥Á°·≈â«
°“√π”¢âÕ¡Ÿ≈®“°°“√ ”√«® ∂“π°“√≥凥Á°„π ª√–‡∑»‰∑¬ æ.». 2548-2549 ¡“„™â«‘‡§√“–Àå ”À√—∫
°“√»÷°…“π’È ¡’¢âÕ®”°—¥∑’ËÕ“®¡’º≈μàÕº≈°“√»÷°…“ °≈à“«
§◊Õ ¢âÕ¡Ÿ≈π’ȇªìπ°“√ ”√«®μ—«Õ¬à“ß ‰¡à„™àª√–™“°√∑—ÈßÀ¡¥
·¡â«à“®–‰¥â¡’°“√ ÿà¡μ—«Õ¬à“ß„π√–¥—∫®—ßÀ«—¥‡æ◊ËÕ„Àâ “¡“√∂‡ªìπμ—«·∑π¢Õß®—ßÀ«—¥μà“ßÊ ·≈â«°Áμ“¡ ·μà®–
‡ÀÁπ«à“ ®”π«π§√—«‡√◊Õπ∑’Ëμ°‡ªìπμ—«Õ¬à“ߢÕß·μà≈–
®—ßÀ«—¥ (¬°‡«âπ °√ÿ߇∑æ) ¡’ª√–¡“≥ 900 - 1,200 §√—«
‡√◊Õπ ®÷ß¡’®”π«π μ√’«—¬‡®√‘≠æ—π∏ÿå ®”π«π∫ÿμ√‡°‘¥√Õ¥
∑’ˇªìπ¢âÕ¡Ÿ≈ ”§—≠¢Õß°“√ª√–¡“≥∑“ßÕâÕ¡‰¡à¡“°π—°
μ“¡‰ª¥â«¬ (μ“√“ß∑’Ë 1) ‡¡◊ËÕ®”π«π μ√’«—¬‡®√‘≠æ—π∏ÿå
·≈–®”π«π∫ÿμ√‡°‘¥√Õ¥¡’‰¡à¡“° ‡æ√“–¿“«–‡®√‘≠
æ—π∏ÿå‚¥¬∑—Ë«‰ª¢Õߪ√–‡∑»‰∑¬‰¥âμË”≈ß¡“°·≈â« ®÷ß
∑”„Àâ ‰¡à§àÕ¬æ∫‡Àμÿ°“√≥å¢Õß∫ÿμ√∑’ˇ ’¬™’«‘μ¡“°π—°„π
·μà≈–°≈ÿà¡Õ“¬ÿ¢Õß μ√’«—¬‡®√‘≠æ—π∏ÿå º≈¢Õß°“√
ª√–¡“≥§√—Èßπ’È®÷ßÕ“®§≈“¥‡§≈◊ËÕπ Ÿß ¥—ß®–‡ÀÁπ‰¥â®“°
∑’ˉ¡à “¡“√∂ª√–¡“≥Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªï ¢Õß
®—ßÀ«—¥ ߢ≈“·≈–¿Ÿ‡°Áμ‰¥â ‡æ◊ËÕ„Àâº≈°“√»÷°…“‡ªìπ∑’Ë
¬Õ¡√—∫¡“°¢÷È𠧫√∑’Ë®–¡’°“√ª√–¡“≥®“°¢âÕ¡Ÿ≈
”¡–‚πª√–™“°√‡æ◊ËÕ»÷°…“§«“¡ Õ¥§≈âÕߢÕß·π«-
‚πâ¡¢Õß§à“ª√–¡“≥Õ—μ√“쓬‡¥Á°Õ“¬ÿμË”°«à“ 5 ªïπ’È
Journal of Health Science 2009 Vol. 18 No. 6
824
‡∑’¬∫°—π√–À«à“ß·À≈àߢâÕ¡Ÿ≈∑—Èß Õß ‡æ√“–¢âÕ¡Ÿ≈
”¡–‚πª√–™“°√„Àâ¿“æ¢Õß∑ÿ°§√—«‡√◊Õπ‰¡à „™à§√—«
‡√◊Õπμ—«Õ¬à“ߥ—߇™àπ°“√ ”√«®
®“°º≈°“√»÷°…“§√—Èßπ’È™’È„Àâ‡ÀÁπ«à“ À“°μâÕß°“√
≈¥¿“«–°“√쓬„π‡¥Á° ‘Ëß ”§—≠∑’ˬ—ßμâÕߪؑ∫—쑧◊Õ°“√
√≥√ߧå„Àâ«—§´’π·°à∑“√°·≈–‡¥Á° ·≈–∑”Õ¬à“߉√„Àâ ª√–™“°√∑’Ë¥âÕ¬‚Õ°“ ‡™àπ ºŸâÕ¬Ÿà„π ∂“π∑’ËÀà“߉°≈
∑ÿ√°—π¥“√ §π∑’ˬ“°®π „À⇢â“∂÷ß·≈–√—∫∫√‘°“√π’È ‰¥â Õ¬à“ß∑—Ë«∂÷ß
°‘μμ‘°√√¡ª√–°“»
¢âÕ¡Ÿ≈∑’Ë„™â„π°“√«‘‡§√“–Àå§√—Èßπ’È ‰¥â√—∫§«“¡Õπÿ‡§√“–Àå
®“° ”π—°ß“π ∂‘μ‘·Ààß™“μ‘ °√–∑√«ß‡∑§‚π‚≈¬’ “√ π‡∑»
·≈–°“√ ◊ËÕ “√ ºŸâ»÷°…“¢Õ¢Õ∫§ÿ≥¡“ ≥ ∑’Ëπ’È
°“√ ◊ËÕ “√ ·≈– Õߧ尓√¬Ÿπ‘‡´ø; 2550.
4. United Nations. Manual X: indirect techniques for de- mographic estimation. New York: United Nations;
1983.
5. United Nations. Step-by-step guide to the estimation of child mortality. New York: United Nations; 1990.
6. Mendoza MO, Kalsbeek DW. A comparison of alter- native variance estimators in demographic surveys.
[cited 2008 Aug 2]; Available from: http://
www.amstat.org/sections/ SRMS/proceedings/
y1983f.html
7. Mosley WH, Chen LC. An analytical framework for the study of child survival in developing countries.
Population and Development Review (Supplement) 1984; 10:25-45.
8. ”π—°ß“π§≥–°√√¡°“√æ—≤π“°“√‡»√…∞°‘®·≈– —ߧ¡·Ààß™“μ‘.
∂‘μ‘¢âÕ¡Ÿ≈§«“¡¬“°®π·≈–°“√°√–®“¬√“¬‰¥â ªï 2531 - 2550.
[ ◊∫§âπ‡¡◊ËÕ 20 ¡’π“§¡ 2552]; ·À≈àߢâÕ¡Ÿ≈: http://www.
nesdb.go.th/Default.aspx?tabid=356
9. ”π—°ß“π§≥–°√√¡°“√æ—≤π“°“√‡»√…∞°‘®·≈– —ߧ¡·Ààß™“μ‘.
Gross Regional and Provincial Product 2000 - 2007.
[ ◊∫§âπ‡¡◊ËÕ 20 ¡’π“§¡ 2552]; ·À≈àߢâÕ¡Ÿ≈: http://
www.nesdb.go.th/Default.aspx?tabid=96
10. °√¡§«∫§ÿ¡‚√§μ‘¥μàÕ °√–∑√«ß “∏“√≥ ÿ¢. √ÿª°“√
ª√–‡¡‘πº≈§«“¡§√Õ∫§≈ÿ¡¢Õßß“π √â“߇ √‘¡¿Ÿ¡‘§ÿâ¡°—π‚√§
æ.». 2523 - 2542; ‡Õ° “√Õ—¥ ”‡π“; 2543.
11. ”π—°‚√§μ‘¥μàÕ∑—Ë«‰ª °√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢.
°“√ ”√«®§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π¢—Èπæ◊Èπ∞“π
·≈–«—§´’π‚ª≈‘‚Õ „π°“√√≥√ߧå æ.». 2546. °√ÿ߇∑æ¡À“π§√:
Õߧ尓√ ߇§√“–Àå∑À“√ºà“π»÷°; 2547.
12. ”π—°‚√§μ‘¥μàÕ∑—Ë«‰ª °√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢.
°“√ ”√«®§«“¡§√Õ∫§≈ÿ¡¢Õß°“√‰¥â√—∫«—§´’π¢—Èπæ◊Èπ∞“π
·≈–«—§´’π„ππ—°‡√’¬π æ.». 2551. °√ÿ߇∑æ¡À“π§√: Õߧ尓√
߇§√“–Àå∑À“√ºà“π»÷°; 2551.
‡Õ° “√Õâ“ßÕ‘ß
1. WHO. World health statistics 2007. Geneva: World Health Organization; 2007.
2. United Nations. United Nations Millennium Declara- tion. New York: General Assembly Resolution 55/2;
18 September 2000; 2000.
3. ”π—°ß“π ∂‘μ‘·Ààß™“μ‘·≈–Õߧ尓√¬Ÿπ‘‡´ø. √“¬ß“πº≈°“√
”√«® ∂“π°“√≥凥Á°„πª√–‡∑»‰∑¬ ∏—𫓧¡ æ.». 2548 - 情¿“§¡ æ.». 2549 (√“¬®—ßÀ«—¥). °√ÿ߇∑æ¡À“π§√:
”π—°ß“π ∂‘μ‘·Ààß™“μ‘ °√–∑√«ß‡∑§‚π‚≈¬’ “√ π‡∑»·≈–
Abstract Provincial Disparities of Under-five Mortality in Thailand Patama Vapattanawong
Institute for Population and Social Research, Mahidol University Journal of Health Science 2009; 18:816-25.
The mortality among children in Thailand has been improving. Infant and under-five mortality rates are now at quite a low level. However, disparities in child mortality among different areas still exist in Thailand. The objectives of this study were studying the situation of child mortality at provincial level and exploring factors that associate to those mortalities. The data used in this study were provincial data from Thailand Multiple Indicator Cluster Survey. The indirect estimation of child mortality using Trussell version of Brass indirect method was applied in this study.
Results from this study showed that the under-five mortality rates (U5MR) of 24 from 26 sample provinces were in the range of 4.8 (95%CI 4.1, 5.5) -37.1 (95%CI 29.1, 35.1) per 1,000 live births. The lowest U5MR was found in Ratchaburi Province while the highest U5MR was found in Narathiwat Province. It was also found that these U5MRs had negative relationship to vaccine coverage in each province (r = -0.413, p < 0.05). Thus, to reduce child mortality, any vaccination campaigns should be continued in order that all infants and children especially those who are vul- nerable groups receive fully immunization.
Key words: mortality disparities, under-five mortality
