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目的了解中国西部农村地区8省42个项目县儿童患腹泻情况及其影响因素。方法运用多水平模型对该地区数据进行分析。结果调查地区2岁以下儿童腹泻两周患病率为19.3%。腹泻两周治疗率为84.7%,治疗地点以村个体医生(31.6%)和乡卫生院(24.8%)为主。多元分析发现母亲接受产前检查,村卫生室和乡卫生院配备高压消毒锅和口服补液盐可以促进儿童患腹泻两周治疗率的提高。多水平Logistic回归模型,可以将残差分解到各个层次上,使结果更加精确。与多因素Logistic回归相比较,多水平Logistic回归模型拟合结果比较保守。结论母亲提高妇幼保健意识,乡村卫生服务系统加强机构能力建设,可以促进母亲及儿童对医疗服务的利用。
Objective To understand the prevalence of diarrhea and its influential factors in children in 42 counties in 8 provinces and 8 western provinces of China. Methods The multi-level model was used to analyze the data in this area. Results The prevalence of diarrhea in two-week children under 2 years of age was 19.3%. The two-week treatment rate of diarrhea was 84.7%. The treatment sites were village individual doctors (31.6%) and township hospitals (24.8%). Multivariate analysis found that mothers received prenatal care, and village hospitals and township hospitals equipped with autoclaves and oral rehydration salts could promote two-week treatment rates for children with diarrhea. Multi-level Logistic regression model, the residuals can be decomposed into various levels, the result is more accurate. Compared with multivariate logistic regression, multivariate logistic regression model was more conservative. Conclusion The mothers’ awareness of maternal and child health care, rural health service system to strengthen institutional capacity building, can promote the use of medical services by mothers and children.