1996至2017年中国少数民族聚居地区住院分娩率  

Institutional delivery rate in minority inhabited areas of China from 1996 to 2017

作　　者：段蜚蕃 周玉博[2] 李宏田[1] 高燕秋 张亚黎[2] 罗树生[3] 康楚云[3] 刘建蒙[2] Duan Feifan;Zhou Yubo;Li Hongtian;Gao Yanqiu;Zhang Yali;Luo Shusheng;Kang Chuyun;Liu Jianmeng(Institute of Reproductive & Child Health/National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191,China;Institute of Reproductive & Child Health/National Health Commission Key Laboratory of ReproductiveHealth/Office for Maternal & Child Health Statistics of China/Department of Epidemiology & Biostatistics,School of Public Health, Peking University, Beijing 100191, China;Office for Maternal & Child HealthStatistics of China/Department of Maternal and Child Health, School of Public Health, Peking University,Beijing 100191, China)

机构地区：[1]北京大学生育健康研究所/国家卫生健康委员会生育健康重点实验室/北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]北京大学生育健康研究所/国家卫生健康委员会生育健康重点实验室/北京大学公共卫生学院全国妇幼卫生年报办公室/北京大学公共卫生学院流行病与卫生统计学系,北京100191 [3]北京大学公共卫生学院全国妇幼卫生年报办公室/北京大学公共卫生学院妇女与儿童青少年卫生学系,北京100191

出　　处：《中华医学杂志》2019年第27期2135-2140,共6页National Medical Journal of China

基　　金：全国妇幼卫生年报项目(2017和2018年度);西部住院分娩现况研究(2016至2017年).

摘　　要：目的结合国家政策描述我国少数民族聚居地区住院分娩率变化趋势与现状。方法总活产数和住院分娩活产数来自全国妇幼卫生年报,相关政策和民族资料来自国家官方网站。根据政策变化情况,将年份划分为:降消项目实施前(1996至1999年)、降消项目实施期(2000至2008年)和后降消项目期(2009至2017年)。将少数民族自治区、自治州或自治县(旗)定义为少数民族聚居地区;少数民族聚居区县所属民族,依据自身名称或上一级行政区划名称按就近原则划分。纳入分析的少数民族聚居区县共计700个。结果22年间少数民族聚居地区活产数45 684 265,住院分娩活产数35 098 855。1996年平均住院分娩率仅37.5%(696 221/1 856 164),2017年升至99.2%(2 371 209/2 390 131),年均增长4.7%。期间,东中西部住院分娩率同步上升,年均增长率依次3.1%、4.2%和4.9%;地区差距缩小,1996年东西差16%,到2017年<1%;城乡差距也不断缩小,由32.1%缩至<1%。此外,基线水平较低的藏族和彝族聚居区住院分娩率大幅提升,分别上升73和63个百分点。1996年住院分娩率<96%的区县589个,2017年锐减至72个,几乎全部(71个)分布在"三区三州"国家深度贫困地区,主要涉及藏族(58个)和彝族(6个)等。结论22年来中国少数民族聚居地区住院分娩率显著提升,提前达到2020年目标,但有少数西部区县尚未达标(96%),提示西部少数民族聚居区尤其深度贫困地区是全面解决我国住院分娩问题的重点工作区域。Objective To describe the secular trends of institutional delivery (ID) rate in minority inhabited areas of China from 1996 to 2017 according to national health policies. Methods The number of live births and IDs for each county/district in 31 provinces of China were derived from the datasets collected by the Office for National Maternal & Child Health Statistics of China. Information on health policies and ethnical areas was derived from official governmental websites. The calendar years were divided into three periods: pre-program period (1996 to 1999), program implementation period (2000 to 2008) and post-program period (2009 to 2017). Minority autonomous regions, autonomous prefectures, and autonomous counties were defined as minority inhabited areas. The ethnic that a county was classified into was determined by a principle of close proximity to the name of the county or its next higher level administrative division. A total of 700 counties in minority inhabited areas were included in the analysis. Results A total of 45 684 265 live births including 35 098 855 delivered in institutions were analyzed. The ID rate in minority inhabited areas was 37.5%(696 221/1 856 164) in 1996 and 99.2%(2 371 209/2 390 131) in 2017, with an annual growth rate of 4.7%. During the 22-years period, the ID rates in the eastern, central and western regions increased simultaneously, with the annual growth rates of 3.1%, 4.2% and 4.9% respectively. The difference between the eastern and western regions decreased steadily from 16% in 1996 to <1% in 2017 and the difference between the urban and rural areas decreased from 32.1% in 1996 to <1% in 2017. Besides, the ID rates in Tibetan and Yi inhabited areas with lower baseline levels increased 73 and 63 percentage points respectively. The number of counties with the ID rate of <96% were substantially reduced from 589 in 1996 to 72 in 2017;the 71 counties were all located in national deep poverty-stricken areas named Three Districts and Three States, predominantly involving Tibetan (58),

关 键 词：住院分娩率 少数民族 卫生政策 全国妇幼年报 

分 类 号：R17[医药卫生—妇幼卫生保健]