新疆北部牧区居民孕产妇保健服务现状分析

目的:描述新疆牧区牧业人口孕产妇保健服务的利用状况,为新疆牧业医院制定人力资源配置规划及能力建设目标提供决策依据。方法:采用分层整群抽样的方法,对新疆3个牧业县1055户游牧和665户定居牧业人口家庭中15～49岁已婚育龄妇女进行家庭健康询问调查并进行比较分析。结果:2008年新疆牧区15～49岁已婚育龄妇女产前检查率为91.9%(游牧90.7%,定居93.3%)、住院分娩率70.0%(游牧65.5%,定居75.3%)、产后访视率21.7%(游牧17.4%,定居26.8%),均远低于2008年全国平均水平;44.8%的孕产妇没有接受孕早期产前检查,在乡镇卫生院、县级及以上医院产前检查的比例较高;非住院分娩妇女中69.7%是由接生员/村医和家人/朋友接生,可及性差是导致新疆牧区孕产妇在家中分娩最主要的原因;新疆牧区游牧产妇的住院分娩率和产后访视率低于定居者;游牧孕产妇保健的可及性低于定居家族。结论:新疆北部牧区牧民孕产妇保健服务需要量大且远未被满足,政府在牧区尤其是游牧点应加大卫生投入,加快建立健全健康保障制度和牧民医疗救助制度,改善妇女的孕产期保健服务利用状况。

Analysis on current status of health care services for pregnant and postpartum women of livestock population in northern pastoral areas of Xinjiang

Objective:To describe the current status of health care services for pregnant and postpartum women of livestock population in northern pastoral areas of Xinjiang and provide a basis for decision-making for staffing planning and capacity-building of pastoral hospitals in Xinjiang.Methods:Married women at child-bearing age aged 15～49 years old from 1 055 nomadic families and 665 resident families in three animal husbandry counties of Xinjiang were selected by stratified cluster sampling method,then they were surveyed by family health questionnaires.Results:The rate of prenatal examination was 91.9%in 2008,90.7%for nomadic women and 93.3%for resident women.The rate of delivery in hospital was 70.0%,65.5%for nomadic women and 75.3%for resident women.The rate of postnatal visit was 21.7%,17.4%for nomadic women and 26.8%for resident women.The rates of prenatal examination,delivery in hospital and postnatal visit of married women in northern pastoral areas of Xinjiang were significantly lower tban national average level.44.8%of the pregnant women didn't receive early prenatal examination,distributing in township town hospitals,hospitals at or above county level.69.7%of the women who didn't delivery in hospital delivered aided by midwives/village doctors and families/friends,and the main effect factors low delivery rate in hospital was poor accessibility.The rates of delivery in hospital and postnatal visit in nomadic women were significantly lower than those in resident women.The accessibility of maternal health care in nomadic women was lower that in resident women.Conclusion:Maternal health care requirement is large and far from being met for pregnant and postpartum women of livestock population in northern pastoral areas of Xinjiang.The government should increase health investment in pastoral areas,especially in nomadic point,speed up the establishment of a indemnity system of health protection and medical assistance system for livestock population to improve the utility of maternal health services.