四川贫困农村妇幼健康状况与服务利用分析.docVIP

四川贫困农村妇幼健康状况与服务利用分析 【摘要】分析秦巴卫生项目干预下四川贫困地区妇幼健康状况和服务利用的变化及其影响因素。方法采取分层多级抽样方法，选取项目干预地区的部分乡镇及其村民作为实验组，选择具有可比性的非项目地区乡镇及其村民作为对照，比较具有代表性的妇幼卫生指标。采用多元回归分析影响妇幼卫生服务利用的因素。结果项目地区新法接生率、住院分娩率、孕产妇/儿童系统管理率、孕产妇/儿童死亡率均逐年改善（P＜0.05），优于非项目地区。多因素研究表明，影响住院分娩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等。结论四川项目地区妇幼卫生干预实施8年来促进了妇幼保健服务利用；干预项目结束后应重点发展经济、提供健康保障措施、加强预防保健和健康教育、增加特困医疗救助，以促进妇幼保健水平持续提高。 【关键词】 秦巴卫生项目 妇幼卫生 卫生服务利用 康公平性 An Analysis of the Maternal and Child Health Service Utility in Poor Rural Area of Sichuan Province CHEN Wen-xian1,LI Ning-xiu2,REN Xiao-hui2 （1.West China Second Hospital,Sichuan University,Chengdu 610041,China;2.West China School of Public Health,Sichuan University,Chengdu 610041,China） Abstract：Objective To evaluate the intervention effects of Maternal and Child Health（MCH）of Qinba Health Project(QBSP)in Sichuan province，and to analyze its influence factors of health service utility.Methods Selected 27 towns and its 81 villages and corresponding villagers in 9 programmed counties in Sichuan province by the method of random layer sampling.3 non-programmed counties and corresponding villages and villagers as control group were selected,which similar with programmed counties of MCH status by the same sampling.Then the indicators of MCH service utility with control group were compared, and the influence factors of MCH service utility with multiple variable regression model were analyzed.Results The main indicators of MCH service utility in the programmed towns were all been improved annually(P＜0.05),and were better than that of non-programmed towns.The logistic regression model showed that the main influence factors to MCH service utility were age of delivery woman,annual average income of the family,health insurance status, times of pre-delivery visit,whether sponsor for poverty,and the score of MCH knowledge test.Conclusions The intervention in the programmed area is effective and better than the non-programmed area.Several ways were suggested to improve the