国家基本公共卫生服务项目妇幼健康管理贵州省2009-2015年执行情况及实施效果分析  

Comprehensive assessment on implementation and effect of basic public maternal and child health service in Guizhou Province from the year 2009 to 2015

作　　者：冯海哲[1] 张玉琼[2] 郑一坷 张谊[1] 张玲[1] 韩燕[1] 何蕾[1] 

机构地区：[1]贵州省疾病预防控制中心妇幼保健所儿童保健科,贵州贵阳550004 [2]贵州省疾病预防控制中心,贵州贵阳550002 [3]贵州省卫生计生委基层卫生处,贵州贵阳500001

出　　处：《现代预防医学》2017年第10期1814-1818,共5页Modern Preventive Medicine

基　　金：贵州省基本公共卫生项目妇幼健康管理实施现状及对策研究;贵州省卫生计生委科学技术基金项目(gzwjkj2015-1-005)

摘　　要：目的了解贵州省2009-2015年国家基本公共卫生服务项目妇幼健康管理服务(0~3岁儿童和孕产妇)执行情况以及实施效果,为加快推进基本公共卫生服务均等化提供参考。方法采取多阶分层随机抽样的方法在72县(区)144个乡镇(社区)进行问卷调查,运用熵权TOPSIS法分析孕产妇和3岁以下儿童健康档案的真实性、规范性、健康管理服务满意度等服务指标,综合评价贵州省各年度对项目执行的优劣情况。采用2009-2015年全省妇幼卫生年报数据,分析孕产妇系统管理率、3岁以下儿童系统管理率等服务指标以及婴儿死亡率、孕产妇死亡率等核心指标变化情况,采用卡方趋势性检验统计推断。结果 2012-2015年全省共调查4 400户,有效调查问卷3 610户,各年度TOPSIS综合排序依次为:2015、2014、2013、2012年。0~3岁儿童、孕产妇真实性档案率,规范性档案率及服务对象满意度均呈上升趋势。城乡婴儿死亡率、5岁以下儿童死亡率及孕产妇死亡率均呈下降趋势,且农村显著高于城市,孕产妇系统管理率、住院分娩率,3岁以下儿童系统管理率等均呈上升趋势,且城乡差距逐年缩小。结论贵州省国家基本公共卫生服务项目实施5年来,有效提升了妇幼保健服务利用度,促进了妇幼健康水平的提高。Objective To understand implementation situation and effect of basic public maternal and child health service package in Guizhou Province from 2009 to 2015, so as to promote the implementation of public health service package. Methods Data were collected with a questionnaire survey among urban and rural residents from twenty-seven districts and 45 township hospitals and grass-root public health service centersusing random layer sampling method. This study applied ideal solution （TOPSIS） methods to evaluate the authenticity, effectiveness, feasibility, satisfaction degree of basiepublie maternal and child health service of the package implementation in the whole province. The maternal and child health annual report from 2009-2015 in Guizhou were collected and analyzed by ehi-square test. Results A total of 4400 families were surveyed with questionnaires. Among them, 3610 were eligible.According to the combined evaluation score oITOPSIS, the ranking order of year of the implementation of the package was 2015,2014,2013 and 2012 from high to low. Authenticity of health record, established well health record and satisfaction degree on health service were on the rise in the group of 0 to 3 years old children and maternal.In the period 2009-2015 the maternal system management,maternal hospital delivery, system management of children under 3 and health care coverage of children of 5 years old and below in Guizhouwere on the rise, with statistical significance by ehi-square test （P〈0.05）.The infant mortality,mortality of children under 5, maternal mortality declined inthe urban area and rural area in Guizhou Province from 2009 to 2015. The infant mortality, mortality of children under 5 and maternal mortality in rural area was significantly higher than that in urban area. The gap between urban and rural areas reduced year by year. Conclusion The 5-year intervention in the basic public health servieein Guizhou effectively improvedthe utility of MCH Service.

关 键 词：基本公共卫生服务 综合评价 TOPSIS 实施效果 

分 类 号：R193[医药卫生—卫生事业管理]