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目的:分析2009、2011及2012年宁夏回族自治区同心县农村育龄妇女产前、产时及产后保健服务利用的变化情况,为制定有效的农村孕产妇保健干预措施提供科学依据。方法:通过哈佛合作基金项目“创新支付制度,提高卫生服务效益”的相关数据,筛选关键指标,反映同心县农村育龄妇女孕产期保健利用水平的变化及存在的问题。结果:2009、2011及2012年妇科检查率均处于较低水平,差异有统计学意义(χ2=5.162,P=0.076);产前检查率从79.65%上升至95.83%,差异有统计学意义(χ2=20.125,P=0.000);孕早期检查率从31.64%上升至62.50%,差异有统计学意义(χ2=20.553,P=0.000);住院分娩率从53.09%上升至95.83%;产后访视率从50.91%下降至16.67%,差异有统计学意义(χ2=24.391,P=0.000);分娩方式以顺产为主,剖宫产率极低,差异有统计学意义(χ2=24.911,P=0.000)。结论:同心县农村育龄妇女孕产期保健服务利用水平总体有所提高,但育龄妇女妇科检查率、孕早期检查率及产后访视率仍处于较低水平,需予以重视和指导。
OBJECTIVE: To analyze the changes of antenatal, postnatal and postpartum health services among rural women of childbearing age in Ningxin Hui Autonomous Region in 2009, 2011 and 2012 and provide a scientific basis for formulating effective rural maternal health care interventions. Methods: The key indicators were screened through the Harvard cooperation fund project “Innovative payment system to improve the efficiency of health services ”, reflecting the change and existing problems of maternal health care and utilization of rural women of childbearing age in Tongxin County. Results: The gynecological examination rates in 2009, 2011 and 2012 were all at a low level with a significant difference (χ2 = 5.162, P = 0.076). The rate of prenatal examination rose from 79.65% to 95.83%, with significant difference (χ2 = 20.553, P = 0.000); the rate of hospital delivery increased from 53.09% to 95.83%; postpartum visit (Χ2 = 24.391, P = 0.000). The main mode of delivery was cesarean delivery, and the rate of cesarean section was extremely low (χ2 = 24.911, P = 0.000). Conclusion: The utilization of maternal health care services of rural women of childbearing age in Tongxin County is generally improved. However, the rate of gynecological examination, early pregnancy checkup and postpartum visiting rate among women of childbearing age is still at a low level, which needs attention and guidance.