文章摘要
陈文贤,李宁秀,何丹,任晓辉.四川省贫困地区妇幼卫生服务效果与影响因素初探[J].中华流行病学杂志,2009,30(3):243-246
四川省贫困地区妇幼卫生服务效果与影响因素初探
An eight-year study on maternal and child health service utility in Sichuan province
投稿时间:2008-10-07  
DOI:10.3760/cma.j.issn.0254-6450.2009.03.010
中文关键词: 妇幼卫生;干预效果;影响因素;秦巴卫生项目
英文关键词: Maternal and child health;Intervention effects;Influencing factors;Qinba health project?
基金项目:世界银行、英国政府赠款和中国卫生部国外贷款办专项经费资助项目(06wst-03)
作者单位
陈文贤 四川大学华西第二医院, 成都 610041 
李宁秀 华西公共卫生学院 
何丹 四川省妇幼保健院项目办 
任晓辉 华西公共卫生学院 
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中文摘要:
      目的 探讨"秦巴卫生项目"在四川省贫困地区实施8年来妇幼卫生服务的干预效果及其影响因素. 方法 采用分层多级抽样选取项目地区15个乡镇作为实验组, 选择具有可比性的非项目地区9个乡镇作为对照组, 比较主要妇幼卫生指标的逐年变化趋势. 采用回归分析影响村民妇幼卫生服务利用的因素. 结果 实验组与对照组在实验前后具有相似的基本特征;实验组新法接生率、住院分娩率、孕产妇儿童系统管理率、孕产妇儿童死亡率6项指标的年均增长率分别为1. 95%、9. 34%、4. 82%、3. 04%、-2. 67%和-13. 84%, χ2趋势检验差异有统计学意义(P<0. 02);实验组6项指标的年均增长趋势优于对照组(P<0. 05). 多因素同归分析表明, 影响服务利用的因素包括年龄、年人均纯收入、是否项目地区、健康保障制度、产前检查次数、是否救助对象和妇幼知识得分. 结论 扶贫项目促进了四川省贫困地区主要妇幼卫生服务利用指标的逐年改善;增进居民的健康服务利用要使扶贫项目与发展经济、提供健康保障措施相结合.
英文摘要:
      Objective To evaluate the effect of intervention on factors influencing the health service utility regarding Maternal and Child Health(MCH)under the 'Qinba Health Project'in Sichuan province. Methods 15 towns in 5 programmed counties were selected, using the method of 'random layer sampling'to be the trial group. With similar MCH status and comparable to the trial group, another 9 towns in 3 non-programmed counties were chosen as the control group, using the same sampling method. Indicators on MCH service utility were compared with that in the control group, and the influencing factors of MCH service utility analyzed by logistic model. Results The main characteristics of the two groups were quite similar at the baseline study, with the average annual family incomes and MCH service per 1000 people. Annual input on MCH services from the government had an distinct increase. The average annual rates of increase regarding the indictors as clean delivery, hospitalized delivery, systematic care on maternal and children, maternal and infant mortality rates were: 1. 95%, 9. 34%, 4. 82%, 3. 04%, -2. 67%, -13. 84%(P<0. 02)through χ2 trend tests. In the trial group, the changes seen in the 6 indicators were better in the control group than in the control group(P<0. 05). Data from the logistic regression model showed that the major influencing factors on the use of hospitalized delivery service were: age of the pregnant woman, average annual income of the family, health insurance status, number of pre-delivery visits, whether on poverty alleviate program, and on knowledge of MCH. Conclusion The intervention project in this programmed area seemed effective and better than the non-programmed area, through an eight-year observation.
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