中国西部县乡级计划生育服务机构宫内节育器服务及管理现况调查  

Enhance the Management of IUD Services in Family Planning Clinics at County and Township Level in Western China

作　　者：贾贤杰[1] 游顶云[2] 周洁[2] 速存梅[2] 杨瑶[2] 赵敏[2] 高一飞[3] 张开宁[4] 

机构地区：[1]蚌埠医学院,蚌埠市233030 [2]昆明医学院 [3]南方医科大学 [4]中山大学健康与人类发展研究中心

出　　处：《国际生殖健康／计划生育杂志》2011年第1期50-53,共4页Journal of International Reproductive Health/Family Planning

基　　金：国家自然科学基金(70763004)

摘　　要：目的:了解中国西部县乡级计划生育服务机构宫内节育器(IUD)放置服务与管理特点,并探讨其成因,为有效提高县级IUD放置服务质量提出建议。方法:根据国家计划生育优质服务县的标准将云南省129个县分为"好""、中等"、"差"3层,每层抽取1个县,进行横断面调查。采用情景分析方法,收集与IUD放置服务和管理相关的数据及资料,并进行深入分析。结果:①计划生育服务机构平均放置IUD种类,县级为(6.17±2.55)种,乡级为(4.08±0.92)种,县级多于乡级(Z=2.37,P=0.023)。②计划生育服务机构人员平均每年人均放置IUD数量,县级为(129.83±47.42)个,乡级为(288.75±35.18)个,县级低于乡级(F=22.26,P<0.000 1)。此外,县级仍在使用一些失败率较高的IUD类型(如某些T型环)。③定性研究结果表明,西部农村IUD失败率较高,与县计划生育服务机构IUD放置服务的管理粗放有密切关系,放置人员与管理人员间沟通、IUD的采购和机构文化都有很大改进空间。结论:西部县计划生育服务机构可通过适当控制IUD种类数和强化IUD服务管理提高服务质量。Objective： 1.To identify the key elements of IUD（intrauterine devices） services in family planning（FP） clinics at county and township level in western China in order to explore the reasons leading to a higher failure rate of IUD use compared with the lower level FP clinics.2.To provide recommendations for enhancing FP service quality at the county level.Methods：Using situation analysis,a cross-sectional study was undertaken in FP clinics within three counties,which were randomly selected out of 129 counties in Yunnan province.Both quantitative and qualitative methods were adopted in data collection and analysis.Results： Averagely,6.17±2.55 types of IUDs were used in FP clinics at county level,while 4.08±0.92 types of IUDs were used at township level,which showed a significant difference（Z=2.37,P=0.023）.Compared with the clinics at township level,lower proportion of IUDs were used in FP clinics at county level recommended by national committee based on evidences of lower failure rate.Moreover,certain types of IUD being reported a high failure rate were still used in county level clinics.The annual number of IUD insertion cases provided by a county FP clinics was averagely 129.83±47.42,while the number was reported 288.75±35.18 at town level,which showed a significant difference（F=22.26,P0.000 1）.It was implicated that weaknesses in service management existed,such as the absence of effective communication between service providers and managers,which may contribute to the use of inappropriate types of IUD and undermine the quality of services.Conclusions： FP clinics at county level in western China should improve service quality by controlling the types of IUDs properly and strengthening the IUD services management.

关 键 词：计划生育服务 卫生保健质量 宫内避孕器 横断面研究 云南 

分 类 号：R169.1[医药卫生—公共卫生与预防医学]