农村孕产期保健服务可及性的定性研究

目的:了解安徽省农村孕产期保健服务可及性,为制定干预方案及改善我国农村孕产期保健服务提供科学依据。方法:选取服务提供者及地方不同级别的关键知情人采用焦点小组访谈和个人深入访谈进行定性调查。结果:产前检查、住院分娩、产后访视和健康教育在乡镇卫生院都已开展,但是数量和质量达不到要求;计划生育部门协助开展了部分孕产期保健服务。近几年,服务提供者提高重视程度、加大经费投入、加强人员培训、加大宣传力度、改变行政管理,提高了孕产期保健服务的可及性。但是也存在资金投入不足、资金分配不平衡、"重临床轻保健"思想、健康教育不足、妇幼保健网络建设不完善、人力制约因素、私人门诊增加等问题,制约了孕产期保健的发展。结论:农村孕产期保健服务取得了一定的成绩,同时也存在着制约服务可及性的问题,应该采取因地制宜的措施,探索新的政府投入方式、乡镇和农村结合的孕产期保健模式,制定统一的孕产期保健服务规范等。

Qualitative study on accessibility of maternal health care service in rural area

Objective:To understand the current situation of accessibility of maternal health care service in rural areas of Anhui province,aiming to institute interventions and provide scientific evidence for improving maternal health care service in China.Methods:Service providers and regional key people who knew the ropes to do qualitative research with focus group discussions and individual interviews were selected.Results:Antenatal checkup,hospital delivery,postnatal visit and health education was developed in township hospitals,but the amount and quality didn't reached the request.Family planning department assisted to develop part of maternal health care service.Recent recognition,devotion of funds,training of staff,propaganda was enhanced,and executive management was changed.The accessibility of maternal health care service was improved.But there were many problems to restrict maternal health care,such as,devotion of funds was insufficient,allocation of funds was imbalance,thought much of clinic but thought less of health care,health education was not enough,the maternal health care network was not perfect,there was restrict factor of manpower,private clinics increased.Conclusion:There are some achievements in maternal health care service in rural areas,but some problems restricts the accessibility of the service.Measures to local conditions should be taken.New style of devotion of government,township-country mode of maternal health care should be probed.Uniform criterion of maternal health care should be established.