卫生服务利用对四川和甘肃省贫困农村地区婴幼儿营养及生长状况的影响  

Effect of utilization of child health services on the nutrition and growth status of infants in poor rural areas in Sichuan and Gansu Province

作　　者：孙畅[1] 孟莎 王庆志 叶睿雪 吴玉菊[1] 曹敏 周欢[1] Sun Chang;Meng Sha;Wang Qingzhi;Ye Ruixue;Wu Yuju;Cao Min;Zhou Huan(Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西公共卫生学院健康与社会行为学系

出　　处：《卫生研究》2019年第5期745-750,共6页Journal of Hygiene Research

基　　金：美国中华医学会基金(No.CMB 09-991);四川大学中央高校基本科研业务费研究专项(No.skqy201537)

摘　　要：目的了解四川和甘肃省贫困农村地区婴幼儿卫生服务利用现状并分析其对婴幼儿营养及生长状况的影响。方法 2014年10-11月,采用多阶段随机整群抽样,在四川、甘肃两省贫困农村地区抽取24月龄及以下婴幼儿及其母亲作为研究对象,通过问卷调查、体格测量、血红蛋白水平检测等了解婴幼儿卫生服务利用和生长发育及贫血情况。运用多因素非条件Logistic回归模型分析婴幼儿营养及生长状况与卫生服务利用的关系。结果 1065名婴幼儿中,低体重、生长迟缓、消瘦患病率分别为3. 38%、10. 52%、2. 25%,营养不良率为12. 58%,贫血率为52. 68%。儿童体检率为37. 09%,体检次数达标率为12. 68%;预防接种率为92. 30%,预防接种次数达标率为48. 73%。调整相关混杂因素后,利用过预防接种(OR=0. 41,95%CI0. 23~0. 74)、预防接种次数达标(OR=0. 58,95%CI 0. 36~0. 92)是婴幼儿营养不良的保护因素;儿童体检次数达标(OR=0. 52,95%CI 0. 35~0. 79)是婴幼儿贫血的保护因素。结论合理的卫生服务利用与减少四川省、甘肃省贫困农村地区婴幼儿营养及生长状况的不良结局有关。OBJECTIVE To investigate the current situation of the utilization of infant and young child health services in pool rural areas where minorities gathered in Sichuan and Gansu Province and analyze its effect on infant nutrition and growth.METHODS We choosed 1065 infants and young children aged≤24 months with their mother as the subjects by multistage cluster random sampling in October to November 2014 in poor rural areas where ethnic minorities gathered in Sichuan and Gansu Province.Questionnaires were used to obtain the data of demography and utilization of maternal and child health services,physical examination to obtain the data of growth status,and hemoglobin detection to obtain the hemoglobin level. The relationship between the nutrition and growth status and maternal and child health service utilization was analyzed by the unconditioned Logistic regression analysis. RESULTS Among the surveyed infants and young children,the underweight rate was 3. 38%,the stunting rate was 10. 52%,and the wasting rate was 2. 25%,the malnutrition prevalence was 12. 58%,and the anemia prevalence was 52. 68%. The children’s physical examination rate was 37. 09%,and the systematic management( frequency of physical examination reached the standard) rate of children was 12. 68%. The rate of prophylactic inoculation was 92. 30%,and the rate of reaching the standard of vaccination frequency was 48. 73%. After adjusting the confounding factors,the result showed that utilization of vaccination( OR = 0. 41,95% CI0. 23-0. 74) and vaccination frequency reaching the standard( OR = 0. 58,95%CI 0. 36-0. 92) were protective factors for infant malnutrition. Children ’s physical examinations frequency reaching the standard( OR = 0. 52,95%CI 0. 35-0. 79) was a protective factor for infant anemia. CONCLUSION Reasonable utilization of health services can reduce the poor result of nutrition and growth of infants in poor rural areas where ethnic minorities gather in Sichuan and Gansu provinces.

关 键 词：婴幼儿 营养不良 贫血 卫生服务利用 贫困地区 

分 类 号：R153.2[医药卫生—营养与食品卫生学] R174[医药卫生—公共卫生与预防医学]