中国已婚育龄妇女分娩保健服务的状况与变化研究

目的:分析我国已婚育龄妇女分娩保健服务状况及其变化。方法:对全国31个省(直辖市、自治区)抽取的调查前三年有生育史的1962名已婚育龄妇女进行问卷调查,结合1997年全国人口与生殖健康调查资料,对两次调查前三年有生育史妇女最近一次活产的分娩保健服务状况进行比较分析。结果:①与1997年调查前三年相比,2001年调查前三年育龄妇女的入院分娩率增加,家庭分娩的比例明显减少;②农村妇女家庭分娩比例明显降低,由1997年调查时的61·41%降为2001年调查时的40·78%,1998~2000年间,92·54%城镇妇女接受分娩保健服务,农村妇女家庭分娩比例高出城镇7·4倍,为40·78%;③分娩保健服务在各地区发展不平衡,东部和中部地区发展快,西部地区,尤其是西南地区发展相对较慢,1998~2000年间,西部地区妇女中,一半以上在家分娩,西部地区农村家庭分娩妇女一半以上由家人接生,约为东部和中部地区的6倍;④少数民族妇女家庭分娩和由家人接生的比例明显高于汉族妇女;⑤随着文化程度和经济收入的增加育龄妇女对分娩保健服务的利用增加,文盲、经济收入低的妇女家庭分娩比例和由家人接生的比例非常高。结论:我国分娩保健服务状况在改善,但发展极不平衡,西部地区农村的分娩保健服务急待提高。应加强对西部地区分娩保健服务的支持力度,研究制定应对策略,加强对西部农村接生人员的专业技术培训。

Study on the status and changes of delivery care services of married childbearing women in China

Objective:To analyze the status and changes of delivery care services of married childbearing women in China. Methods:Questionnaire-based survey was conducted among 1962 married childbearing women who delivery during the three years prior to the 2001 NDRHS. The status and changes of the latest delivery care services of married childbearing women was analyzed during three years prior to 2001 NDRHS compared with that of 1997 NDRHS. Results:(1)the rate of hospital delivery increased considerably, while the rate of home delivery decreased evidently during the three years prior to the 2001 survey compared with the 1997 survey; (2) The proportion of home delivery in rural areas decreased considerably, from 61.41 % to 40.78 %. More than 92 % of urban women received delivery care services during 1998 to 2000. The proportion of home delivery in rural areas was about 41 %, which was 7.4 times higher than that in urban areas; (3) Improvement of delivery care services varied between geographic areas. The proportion of women who received birth delivery care increased rapidly in the east and the central regions, but slowly in the west, especially in the southwest. During 1998 to 2000, more than a half of women in the west region gave birth at home, and more than a half of rural women who had birth delivery at home were aided by family members in the west region, about 6 times as that in the east and the middle regions; (4) Women of minority ethnic groups were much less likely to attend delivery care services than Han women, but more likely to give birth at home and to be attended by family members; (5) Women tended to make better use of delivery care services with the rise of their educational level and family income. Women who were illiterate or women with low income had higher proportions of home delivery and family member-aided delivery. Conclusion:there was an improvement in birth delivery care services but the improvement was unbalanced. It urgently needed to improve delivery care services in western China especially in rural areas. More extensive efforts should be made to enhance delivery care services for the western region and for the vulnerable groups. It is urgent to consider the further study on the countermeasure against home delivery in high state and the training for midwife should be strengthened in rural areas of western China.