摘要
目的了解克拉玛依妇幼保健服务现状,分析服务模式利与弊,探索解决问题的对策。方法采用定量研究和定性研究相结合的方法。通过产科质量评估,与相关妇幼保健专家访谈,开展基线调查等进行定性分析,收集近五年妇幼卫生年报运用EXCEL2007和SPSS17. 0对妇幼保健服务指标、健康指标进行定量分析。结果 (1)市妇幼保健所为市疾病预防控制中心的一个科室,履行市级妇幼保健机构职能。助产服务依托4家综合医院产科,妇幼保健服务由社区卫生服务中心(乡卫生院)承担。(2)全市社区卫生服务中心妇幼保健专业技术人员45人,占从事妇幼保健服务人员总数28. 48%。高级职称仅1人,占0. 63%,大学以上学历17人,占10. 76%,年龄40岁以上29人,占64. 4%。(3)全市产妇数、产检率、产检≥5次、产后访视率及住院分娩率近五年呈上升趋势并保持较高水平。各年度比较差异有统计学意义(P <0. 01)。孕产早检率、系统管理率均低于同期全国的平均水平。全市5年平均剖宫产率59. 77%,高于全区和全国平均水平。高危孕产妇占比呈现明显上升趋势,5年高危孕产妇占孕产妇总数的33. 36%。巨大儿发生率逐年上升,平均发生率为13. 78%。各年度比较差异有统计学意义(P <0. 01)。近5年全市孕产妇平均死亡率为26. 89/10万,高出全国同期(20. 1/10万) 6. 79个百分点。2013-2014年孕产妇死亡有抬头趋势,总体死亡率变化趋势差异有统计学意义(P <0. 05)。结论 (1)克拉玛依市妇幼保健服务体系不完善,机构不健全。(2)全市妇幼保健管理模式呈分段、分级管理。基层妇幼保健专业技术人员短缺,尤其高级人才缺乏,服务能力明显不足。(3)高危孕产妇数量逐年递增,巨大儿发生率呈上升趋势,剖宫产率常年以地州为单位居全自治区前列。建议(1)建立健全地市、县区、乡(社区卫生服务中心)三级妇幼保健机构。(2)综合医院�
Objective To understand the current situation of maternal and child health care services in karamay,analyze the advantages and disadvantages of service modes,and explore the countermeasures to solve the problems.Methods A combination of quantitative research and qualitative research was used.Through obstetric quality assessment,interviews with relevant maternal and child health experts,based on a baseline survey,qualitative analysis was conducted.The annual report on maternal and child health in the past five years was used to quantitatively analyzed.The indicators of maternal and child health services and health indicators were analyzed by EXCEL 2007 and SPSS 17.0.Results ① The Karamay Maternal and Child Health Care Center is a department of the Municipal Center for Disease Control and Prevention that performs the functions of a municipal-level maternity and child care agency.Midwifery services rely on the obstetric departments of 4 general hospitals,and maternal and child health services are undertaken by the community health service centers (township health centers).② There are 45 maternal and child health professional and technical personnel in all community health service centers in the city,accounting for 28.48% of the total number of maternity and child care services personnel.Only one person has a senior professional title,accounting for 0.63%.There are 17 professional workers with bachelor degree or above,accounting for 10.76%.There are 29 professional workers aged over 40 years old,accounting for 64.4%.③The number of pregnant women in the city,the antenatal examination rate,the times of antenatal examination ≥ 5 times,the rate of postpartum visit and the rate of hospital delivery have shown an upward trend in recent five years and maintained a relatively high level in the past five years.There were statistically significant differences among different years (P< 0.01).The rate of early antenatal examination and the rate of systematic management were lower than the national average.The average ces
作者
朱芳
冉秀文
买热也木尼沙.库尔班
帕提曼.米吉提
董月莲
ZHU Fang;RAN Xiu Wen;MaiReMuNiSha;PaTiMan;DONG Yue Lian(Karamay City Disease Prevention and Control Center,Karamay,Xinjiang 834000,China;Karamay Central Hospital,Karamay,Xinjiang 834000,China)
出处
《中国妇幼卫生杂志》
2018年第6期35-39,共5页
Chinese Journal of Women and Children Health
基金
新疆克拉玛依市科技计划立项课题(JK2016-12)
关键词
妇幼保健
现状
对策
maternal and child health care
status quo
countermeasures
