利用结核防治服务干预策略改善中国流动人口结核防治工作的回顾与.docVIP

利用结核防治服务干预策略改善中国流动人口结核防治工作的回顾与评价( 陈涛，汪洋，唐晓君* ，曾缓，刘晓雪 （重庆医科大学公共卫生学院　重庆 400016） 摘 要：目的 回顾既往的及正在执行的与健康公平性相关的扶贫项目及结核病控制项目在提高流动人口对结核病服务获得和利用方面所采取的相关政策、文件、措施、干预或活动，并评价其效果和影响，为进一步开展结核病防治工作提供依据和建议。方法 借鉴循证医学系统评价方法，对文献进行系统回顾和评价，同时结合定性研究方法。 结果 各地将流动人口结核控制工作纳入当地结核防治规划，采取综合干预措施，包括健康促进、提供激励、对病人实行督导管理等，其效果评价：在已发表文献中有7篇报告采取不同干预后在提高病人知识知晓率、结核发现率、治愈率是有效的。定性研究结果显示：流动人口追踪督导困难，结核病人及疑似病例对于结核的防治知识及免费政策知晓不够，出现有关症状后不知道到结防所去检查。 结论 应开展更多的专门针对流动人口及弱势人群结核控制的实施性研究，加强流动人口管理，加大落后地区，边远地区健康宣传和经费投入的力度与深度。 关键词：结核防治；流动人口；回顾与评价 Review and Assessment of Pro-poor Initiatives in TB Control Programmes Among Floating Population in China CHEN Tao，WANG Yang,TANG Xiao-jun,ZENG Huan,LIU Xiao-xue （The school of public health,Chongqing Medcial Uniersity, Chongqing 400016，China） Abstact:Objective Reviewing the past and on-going pro-poor programmes related to health equity, and the relevant policies, documents, and interventions for promoting the Floating population’s accessibility and utilization of TB control services in TB control programmes, then evaluate their impacts and influences to provide evidences and suggestions for the further work of TB prevention and treatment. Methods Referring to systematic review in Evidence-Based Medicine, the enrolled literatures were systematic reviewed and qualitative study was integrated. Results Relevant documents and policies are issued in each area to strengthen the migrant TB control. Comprehensive intervention measurements are adopted including health promotion, providing incentive, Patient tracing and supervision management and so on. Impact Evaluation: For published literature, there are 7 in which the awareness rate, detection rate and cure rate have increased after various intervention initiatives were implemented.The qualitative study finds: tracing and supervision for migrants are difficult to practice. TB patients as well as suspect ones do not have enough knowledge on TB prevention and free of charge policies. And they do not have the realization of going