中国15省孕妇产前检查服务利用公平性及其变化  

Status and relative changes of equality of antenatal cares among women in 15 provinces in China

作　　者：刘雅倩 冯星淋[1] LIU Yaqian;FENG Xinglin(Department of Health Policy and Management,Peking University)

机构地区：[1]北京大学公共卫生学院卫生政策与管理学系,100191

出　　处：《中国生育健康杂志》2022年第5期401-406,414,共7页Chinese Journal of Reproductive Health

摘　　要：目的 探究1990-2015年中国部分地区妇女产前检查服务利用情况及其公平性变化,为进一步改善产前检查服务公平性提供依据与建议。方法 本研究基于1990-2015年中国健康与营养调查(CHNS)数据库,纳入数据库中1990-2015年有分娩行为的妇女,评价指标采用产检次数达标率。利用Logistic回归分析影响妇女产检次数达标率的因素,并利用极差法与集中指数法进行公平性分析。结果 1990-2015年产检次数达标率由12.98%上升至59.68%。Logistic分析结果显示,城市妇女达标率高于农村妇女,随受教育程度与家庭收入的升高,产检次数达标率也呈现上升趋势。极差法与集中指数法分析结果显示,1990—2015年间产检次数达标率公平性呈现先上升后下降的趋势,其中地区与受教育程度对不公平性的贡献比例有所增加。结论 随着社会经济水平的提升,产检次数达标率呈现上升趋势,国家基本公共卫生服务对产检次数达标率公平性的改善具有促进作用。在今后基本公共卫生服务持续推进的过程中,应注意城市与农村地区之间的差异,同时加强对所有妇女的健康教育,以通过提高所有妇女的健康意识来改善服务覆盖率与公平性。Objective To explore the utilization and changes of equity in prenatal care services among women in 15 provinces of China during 1990-2015, in order to provide evidence and suggestions for further improving the equity of prenatal care services. Methods This study was conducted based on the China Health and Nutrition Survey(CHNS) database from 1990 to 2015. All women surveyed from 1990 to 2015 were included in the study. The evaluation index was the proportion of women with at least 5 prenatal visits. Logistic regression was used to analyze the factors affecting the proportion of women with at least 5 prenatal visits, and the equality was analyzed using range method and concentration index method. Results From 1990 to 2015, the proportion of women with at least 5 prenatal visits increased from 12.98% to 59.68%. Logistic regression showed that the proportion of women with at least 5 prenatal visits in urban areas was higher than that of rural areas. With the increase of educational level and family income, the proportion of women with at least 5 prenatal visits also showed an upward trend. The analysis of range method and concentration index method showed that the equality of the proportion of women with at least 5 prenatal visits increased first and then decreased during 1990-2015, and the contribution of region and educational level to the inequality increased. Conclusion With the improvement of social-economic level, the proportion of women with at least 5 prenatal visits showed an upward trend, and the National Basic Public Health Service plays a promoting role in the improvement of the equality. In the process of continuous promotion of Basic Public Health Services in the future, attention should be paid to the differences between urban and rural areas, and health education should be strengthened among all women, so as to improve service coverage and equality by raising health awareness.

关 键 词：产前检查 影响因素 公平性 

分 类 号：R17[医药卫生—妇幼卫生保健]