摘要
目的分析中国区县妇幼保健综合水平,识别妇幼保健薄弱区县及其薄弱点,为开展妇幼保健精准帮扶提供依据。方法结合文献法和专家法筛选全国妇幼卫生年报指标,构建评价指标体系。采用加权秩和比(RSRw)法综合筛选出的指标获得综合指标RSRw,据此将全国所有区县均分为4类(第1类妇幼保健水平最优,第4类最薄弱)。针对第4类区县及其中最薄弱的100个区县(简称"100区县")开展空间分布分析和相关指标分析。结果共筛选出11项指标,全国2876个区县RSRw值范围为0.0053~0.8915,1~4类区县个数依次为720、719、718和719。第4类区县和100区县主要分布在农村地区(分别为606个和95个,占比84.3%和95.0%)和西部地区(分别为414个和92个,占比57.6%和92.0%),其孕产妇死亡率(21.1/10万、43.9/10万)分别为全国平均水平(12.2/10万)的1.7倍和3.6倍,5岁以下儿童死亡率(7.0‰、14.2‰)分别为全国平均水平(4.8‰)的1.5倍和3.0倍。结论妇幼保健薄弱区县集中分布于经济发展水平相对较差的农村地区和西部地区,通过综合措施降低孕产妇死亡率和5岁以下儿童死亡率仍是薄弱地区开展妇幼保健工作的重点。新时期宜加强探索妇幼精准帮扶模式,强化倾斜政策,共享发展成果。
Objective To evaluate the overall quality of maternal and child health care of all counties in China,as well as to identify the relatively weaker counties and their weak links to provide references for the targeted assistance of maternal and child health care.Methods An evaluation index system was established by using the combined method of literature review and expert consultation,by screening indicators of National Maternal and Child Health Statistics(NMCHS).Weighted rank-sum ratio(RSRw)method was adopted to obtain the comprehensive measure towards the RSRw of each county.According to the values of RSRw,all counties were ranked and further sorted into four categories(The first category had the best quality of maternal and child health care,and the fourth category had the weakest).Analysis of spatial distribution and individual indicator level were performed among the fourth category counties and the weakest 100 counties,with the lowest quality of maternal and child health care in China(called as“100 counties”).Results 11 indicators were included in the analysis.The RSRw values of 2,876 counties in China ranged from 0.0053 to 0.8915,and the numbers of four categories of counties were 720,719,718,and 719,respectively.The fourth category counties and“100 counties”were mainly distributed among the rural(606 and 95,accounting for 84.3%and 95.0%respectively)and the western region(414 and 92,accounting for 57.6%and 92.0%respectively).The maternal mortality rates of the fourth category counties(21.1/100,000)and“100 counties”(43.9/100,000)were 1.7 and 3.6 times as high as the national average level(12.2/100,000)respectively.The under 5 mortality rates(7.0‰,14.2‰)were 1.5 and 3.0 times as high as the national average level(4.8‰)respectively.Conclusion The weaker counties were mainly distributed among the rural and the western region with a relatively poor level of economic development.Reducing the maternal mortality rate and the under 5 mortality rate through comprehensive measures remains the key task
作者
程志浩
周玉博
罗树生
李宏田
刘建蒙
CHENG Zhihao;ZHOU Yubo;LUO Shusheng;LI Hongtian;LIU Jianmeng(Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health/Office for National Maternal and Child Health Statistics of China;Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China)
出处
《中国生育健康杂志》
2020年第4期305-309,共5页
Chinese Journal of Reproductive Health
基金
国家卫生健康委员会妇幼健康精准帮扶区县识别研究项目。
关键词
区县
妇幼保健
综合评价
all counties in China
maternal and child health care
comprehensive evaluation
