农村地区5岁以下留守儿童卫生服务需求及影响因素

目的 了解农村地区5岁以下留守儿童卫生服务需求及影响因素。方法 2017年4月从河北省第五次国家卫生服务调查家庭健康询问调查数据库提取农村地区所有5岁以下儿童信息（1 022人），描述留守与非留守儿童两周患病就诊现况，采用多因素Logistic回归分析其影响因素。结果 河北省农村地区5岁以下留守儿童两周患病就诊率为10.7%（29/270），低于非留守儿童的18.1%（χ2 = 6.71，P = 0.010）。双亲（OR = 7.92，P = 0.034）、单亲（OR = 6.11，P = 0.047）外出务工负面影响了留守儿童的两周患病就诊。相对于居家距离最近的医疗机构距离≥3 km ，距离＜3 km有利于留守儿童的两周患病就诊（OR = 0.06，P＜0.001）。结论 农村地区5岁以下留守儿童卫生服务需求满足程度较低，父母长期外出务工与就诊物理距离的可及性影响了该人群卫生服务需求。建议强化社会支持、合理配置农村卫生资源。

Influencing factors for health demand of ill rural left-behind children under 5 years old

Objective The study examined the status of two-week prevalence of clinical visits of the rural left-behind children (LBC) ≤ 5 years, and explored whether parental migration could affect health demand on this population. Methods A total of 1022 rural children under 5 years in Hebei Province were extracted from the Database of 5th National Health Services Survey to describe the status of two-week prevalence of clinical visits between LBC and non-LBC. Chi-square test and multi-logistic regression were used to explore the influence factors for two-week visiting rates. Results In the rural Hebei Province, the two-week consultation rate of LBC aged ≤5 years was 10.7%, which was lower than that of their peers (18.1%) who parents did not migrate(χ2=6.71, P=0.010). Migrating parents (OR=7.86, P=0.045) and single migranting parent (OR=5.17, P=0.040) had negative influences for two-week prevalence of clinical visit of LBC. LBC with the closest distance <3km from family to the site for health service was more likely to visit a doctor compared to those LBC with closest distance ≥3km from family to the closest site for health service(OR=0.06, P<0.001). Conclusion Rural LBC under 5 years receive less health service. Parents migrating and longer distance from family to the closest site of health service are not good for the health demands of LBC. Therefore, social capital should be provided and health resources should be allocated properly in the rural area.