秦巴卫生项目四川地区妇幼卫生干预效果研究

目的 评价秦巴卫生项目四川地区妇幼卫生领域的干预效果并分析其影响因索,为促进贫困农村卫生发展提供战略思路.方法 采取分层多级抽样方法,选取项目干预地区的部分乡镇及其村民作为实验组,选择具有可比性的非项目地区乡镇及其村民作为对照,比较具有代表性的妇幼卫生指标.采用多元回归分析影响妇幼卫生服务利用的因素.结果 项目县基本达到项目目标要求,项目地区新法接生率、住院分娩率、孕产妇/儿童系统管理率、孕产妇/儿童死亡率均逐年改善(P<0.05),优于非项目地区.多因素研究表明,影响住院分娩服务利用的因素包括年龄、年人均纯收入、是否项目地区、健康保障制度、产前检查次数、是否救助对象和妇幼知识得分等.结论 四川项目地区妇幼卫生干预实施8年来促进了妇幼保健服务利用;干预项目结束后应注重发挥政府在减少健康贫困中的关键作用,重点在发展经济,提供健康保障措施、加强预防保健和健康教育、增加特困医疗救助,以促进妇幼保健水平持续提高.

An Evaluation of the Maternal and Child Health Services in Qinba Health Project in Sichuan Province

Objectives To evaluate the effectiveness of interventions taken by Qinba Health Project on the Maternal and Child Health(MCH)services in Sichuan province.Methods Stratified random sampling was undertaken to select participants for the evaluation.Eighty one villages in 27 towns in the nine project counties and 27 villages in nine towns in three non-project counties with similar social economic backgrounds were selected.A questionnaire survey was undertaken in all of the selected health facilities and 462 women who received maternal services during the project time.Multiple variable regression analysis was performed to identify determinants of the change of services.Results The project MCH services reached the expected targets.The project towns improved their MCH services more significantly than the non-project towns.The logistic regression analysis identified project intervention,maternal age,average family income,health insurance,numbers of pre-natal examinations,eligibility to poverty alleviation,and knowledge as key determinants of the improvement of MCH services.Conclusion The project intervention is effective in improving MCH services.However,more attentions to poverty alleviation and health promotion need to be paid.