项目县农村地区产前保健现状及影响因素分析

目的:了解项目县农村孕产妇产前保健服务利用状况,分析其影响因素,为制定干预策略提供依据。方法:采用分层整群抽样的方法抽取样本1223名,运用SAS8.2对资料进行统计分析。结果:产前检查覆盖率为95.58%,5次及以上产检率为62.30%,孕早期检查率为47.44%。是否参加母婴保健保偿制是产前检查覆盖率和5次及以上产检率的主要影响因素,产前检查覆盖率的影响因素还有到最近乡镇卫生院的时间,5次及以上产检率的影响因素还包括已有小孩数和家庭硬件设施。孕早期检查率的影响因素包括已有小孩数、父亲和母亲的年龄以及怀孩子前1年家庭收入。结论:该地区产前保健服务利用率有待提高,是否参加母婴保健保偿制是产前保健服务利用的主要影响因素之一。     

中国农村妇女产前保健影响因素分析

20世纪 90年代 ,中国政府制定和实施了“九十年代中国儿童发展纲要”和“中国妇女发展纲要”,妇女儿童卫生保健工作取得了很大的进展。但是 ,由于我国人口众多 ,地区发展不平衡 ,城乡差距大 ,从总体上看 ,我国妇女儿童的保健服务还处于一个较低的水平 ,有待于进一步提高 ,特别是农村地区 ,妇女儿童的保健工作仍面临着巨大的挑战。本文通过对农村妇女产前保健情况的分析 ,寻找阻碍农村妇女进行产前检查的影响因素 ,探讨提高农村妇女产前检查的方法 ,实现“两纲”提出的妇女儿童发展目标。1　资料与方法利用 1 993年及 1 998年国家卫生服务调…     

南京地区流动孕产妇产前保健利用状况及其影响因素

目的:了解影响流动人口孕产妇产前保健服务利用现状及其影响因素,为今后制定相关卫生工作政策提供参考依据。方法:分层随机抽取409例流动产妇进行问卷调查,调查内容包括社会人口学特征、孕产史、孕早期检查及产前检查次数等情况。结果:调查结果显示,流动人口中孕产妇初次产前检查平均孕周为(21.1±9.1)周,早期检查率仅为24.9%,平均产前检查次数为(6.2±3.6)次,≥5次的产前检查率为56.2%。影响产前保健利用及时性的主要有月人均收入及是否经产;影响产前保健利用足够程度的因素主要有婚姻、文化程度、配偶有无工作、月人均收入及是否经产。结论:流动孕产妇产前保健利用率低,产前保健利用的主要影响因素为婚姻、文化程度、丈夫有无工作、是否经产及经济因素。     

山东省部分地区农村妇女产前保健利用现况及影响因素分析

目的:了解山东省部分地区农村育龄妇女产前保健利用现况及其影响因素。方法:于2009年9月至2010年1月对山东大学卫生研究基地17个村已婚育龄妇女自2004年9月1日以来最后一次分娩的情况进行面对面问卷调查,采用χ2检验和非条件logistic回归模型对产前保健服务利用的影响因素进行单因素和多因素分析。结果:孕产妇产前检查率为94.11%,孕早期检查率为72.54%,产前检查≥5次的比例为38.37%。孕期产前保健利用不足的比例为69.48%,产前保健利用过度的比例为9.00%。研究对象年龄、家庭人均年收入、离医疗机构距离以及是否第一次分娩是影响产前保健服务利用的相关因素。结论:山东省部分地区农村妇女产前保健服务利用不足的比例较高,建议进一步采取措施提高农村妇女产前保健服务利用程度,以提高孕产妇的健康水平和婴儿的出生质量。     

经济欠发达地区农村产前保健项目中间结果评价

目的:对经济欠发达地区农村开展的产前保健项目的中间结果进行评价.方法:由县卫生局组织有关产前保健专家对乡镇卫生院产科医务人员进行业务培训;由县卫生局和乡镇领导协调卫生与计划生育部门开展农村社区产前保健的健康教育;由乡镇卫生院产科助产士负责开展产前检查.应用整群随机分组的设计及做干预前后测量的方法进行评价.评价的指标包括初次产前检查孕周、产前检查次数和产前检查率.结果:干预使孕妇初次产前检查的时间提前.干预提高了产前检查率.干预提高了高危妊娠妇女的产前检查次数.结论:卫生与计划生育部门合作开展产前保健是促进经济欠发过地区农村母婴保健工作可行与有效的途径.     

经济欠发达地区农村产前保健项目对产妇知信行的影响

为探索农村社区产前保健项目对产妇的孕产期健康与保健相关知识、态度和行为的影响 ,采取整群随机抽样的方法确定要调查的村 ,入户问卷调查干预组 41 1名、对照组 442名产妇。结果表明 ,干预组产妇掌握母婴健康保健知识较好、正确或恰当态度率较高、正确行为率较高。但两组产妇对首次产前检查孕周的正确回答率均在 50 %以下 ,对孕期无异常也要定期产前检查的正确态度率不理想 (干预组 61 %、对照组 45% )。说明产前保健项目在一定程度上改善了产妇的知信行 ,但改善的力度还不够大 ,项目有待进一步改进     

农民工孕妇产前保健影响因素

目的了解分析农民工孕妇产前保健情况、存在问题和影响因素,为进一步采取措施改善农民工孕妇产前保健提供信息。方法于2006年7月至2007年11月期间,对在本院产科住院的203名农民工产妇作问卷调查,对早孕检查方法、建立孕产妇联系手册、产前检查次数等产前保健状况进行了描述,并分析影响因素。结果农民工孕妇的产前保健还存在比较大的问题。调查对象中,有30．5％不在医院作早孕确定,有38．4％没有建立孕产妇联系卡,有77．3％没作产前保健或者不足3次。丈夫是否上海户籍、丈夫的经济收入及是否有准生证是影响产前保健的重要因素。结论农民工孕妇产前保健还存在较大问题,其影响因素也是多方面的,包括丈夫是否上海户籍、经济收入及是否有准生证。这些问题都迫切需要政府有专门的措施来解决。     

流动人口孕产妇产前保健服务利用现状及影响因素分析

目的 了解流动人口孕产妇产前保健服务利用情况并分析其影响因素,为改善流动人口孕产妇的产前保健质量、保障其身心健康提供参考。方法 对2018年全国流动人口卫生计生动态监测问卷中的6 285名流动人口孕产妇相关数据进行分析,主要分析方法有统计描述、χ2检验、Fisher精确性检验和二元logistic回归分析等。结果 流动人口孕产妇产前建档率为95.1%,产前检查达标率为88.7%。二元logistic回归分析表明,本人文化程度为初中（OR = 0.358,95%CI:0.196～0.654;OR = 0.651,95%CI:0.454～0.933）、家庭月均收入3 000元以下（OR = 0.394,95%CI:0.236～0.660;OR = 0.419,95%CI:0.293～0.597）、未接受过妇幼和生殖健康教育（OR = 0.512,95%CI:0.397～0.659;OR = 0.756,95%CI:0.639～0.893）的流动人口孕产妇产前档案建立情况和产前检查达标情况均较差,配偶文化程度在初中及以下（OR = 0.592,95% CI:0.424～0.827）的孕产妇产前检查达标情况较差;流入东部地区（OR = 1.436,95% CI:1.071～1.925;OR = 1.394,95%CI:1.138～1.708）的孕产妇产前档案建立情况、产前检查达标情况较好,流动范围为跨县流动（OR = 1.481,95%CI:1.106～1.982）的孕产妇产前档案建立情况较好。结论 流动人口孕产妇产前保健服务利用情况相对较好,但仍存在可改善空间,应继续推进基本公共卫生服务均等化,提高产前保健服务质量。     

不同时期育龄妇女产前保健及影响因素分析

目的了解近10年来我国孕产期保健服务提供状况及不同时期的影响因素。方法采用分层、三阶段的容量比例抽样方法获得调查对象，由调查员入户对其进行面对面的问卷调查。结果产前检查的覆盖率和5次及以上产前检查次数的比例均不断增加，但5次及以上产前检查的比例还较低（〈60％）。不同地区比较，中部地区产前保健利用情况发展较快，西部地区相对较慢。城乡比较，农村发展速度相对较快，但在绝对值上各个时期城市都明显好于农村。因素分析结果显示，妇女分娩时期、妇女居住地以及妇女的家庭和个体特征影响妇女产前检查次数。结论在提高产前检查覆盖率的同时，要不断提高服务质量，提高服务未及人群的服务利用率。     

农村已婚育龄妇女产前保健状况及影响因素分析

目的:了解农村已婚育龄妇女产前保健状况,探讨农村育龄妇女产前保健的影响因素,为孕产期保健提供依据。方法:应用多阶段整群抽样方法选择河北省农村已婚育龄妇女采用面对面的问卷调查方法,对农村已婚育龄妇女进行产前保健状况调查,以产前检查地点为应变量使用累加Logistic模型分析产前检查地点的影响因素。结果:76.5%的已婚育龄妇女进行过产前检查,检查的地点主要是妇幼保健院(42.4%)、其他综合医院(19.4%)。选择检查地点主要原因90.9%觉得交通便利,而未产检的原因61.4%已婚育龄妇女认为不需要或不知道要检查,文化程度、家庭年收入对选择产前检查地点有影响(P<0.05)。结论:增加农民收入,提高农村妇女文化水平,进而改善农村育龄妇女产前保健水平。     

Factors which influence use of prenatal care in low-income racialethnic women in Los Angeles county

There is very limited information on ethnic differences in use of prenatal care services. The purpose of this study was to examine the effect of sociodemographic, health behaviors, medical risk, and psychosocial risk factors on the timing of prenatal care among Black-American, Mexican-American, and recent Mexican immigrant women in Los Angeles. A sample of 107 primiparous women were interviewed using a structured questionnaire. Information obtained included socioeconomic indicators, relationship with baby's father, timing of prenatal care, psychosocial factors, and substance use before pregnancy. Ethnic patterns of timing of prenatal care revealed no significant differences. The relationship with the baby's father was associated with early timing of prenatal care and more prenatal care visits. Substance use before pregnancy was significantly related to total number of visits for this pregnancy.Ruth E. Zambrana is Associate Professor of Social Welfare; Christine Dunkel-Schetter is Associate Professor of Psychology; Susan Scrimshaw is Professor of Public Health and Anthropology; all at University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, California 90024.This study was supported by the following funding agencies: UCLA Center for the Study of Women, UCLA Biomedical Faculty Research Support Grant, UC Mexus Development (Grant DG87-123) and Agency for Health Care Policy and Research (formerly known as National Center for Health Services Research and Technology Assessment (HS/HD #05518-01A 1).     

Accessibility, quality of care and prenatal care use in the Philippines

The patterns and determinants of prenatal care are examined through the use of a randomly selected sample of 3000 rural and urban women who were studied prospectively during pregnancy and at three or four days postpartum. A large number of policy factors were found to influence the choice of most frequently used type of traditional, modern public or modern private prenatal care and the number of visits to each type of care, but few affected the first month of visit. The quality of care provided, accessibility to this care, and insurance available to the mother all had important effects on prenatal patterns. Large differences exist in the set of feasible policy options for improving prenatal care in urban and rural areas.     

The use of QALYs in health care decision making

This paper seeks to highlight some of the critical issues concerning the use of the Quality Adjusted Life Years (QALYs) to measure the outcome of health care choices, in decisions related to both individual patient care and social resource allocation. Much of the support for the QALY is based on its simplicity as a tool for resolving complex choices. However, it may be the case that the QALY is not sufficiently refined or robust, failing perhaps to take into account some of the critical factors which affect preferences over different health care scenarios.     

Associations of government health expenditures,the supply of health care professionals,and country literacy with prenatal care use in ten West African countries

Social and health care context may influence prenatal care use. We studied associations of government health expenditures, supply of health care professionals, and country literacy rates with prenatal care use in ten West African countries, controlling for individual factors. We used data from Demographic and Health Surveys (n = 58,512) and random effect logistic regression models to estimate the likelihood of having any prenatal care and adequate prenatal care. Each percentage increase in the literacy rate was associated with 4% higher odds of having adequate prenatal care (p = .029). Higher literacy rates among women may help to promote adequate prenatal care.     

Unintended pregnancy and women's use of prenatal care in Ecuador

This paper assesses the relationship between unintended pregnancy--both unwanted and mistimed and several dimensions of use of prenatal care among women in Ecuador, where the level of unintended pregnancy has risen considerably in recent years. Data were collected from a nationally representative sample of 3988 women interviewed in the 1994 Demographic and Maternal-Child Health Survey. Multivariate logistic regression was used to assess jointly the effect of pregnancy intention status (unwanted, mistimed, planned) on three aspects of prenatal care use while controlling for potential confounders. Women with unwanted pregnancies were 32% less likely than women with planned pregnancies to seek out prenatal care. Women with unwanted pregnancies were also 25% less likely to initiate care in the first trimester and 29% less likely to receive at least an adequate number of visits. Mistimed pregnancy was not associated with receiving care, timely initiation of care or receiving an adequate number of visits.     

Social work influence on interdisciplinary ethical decision making in health care settings

Because of structural and philosophical changes in health care, social work practitioners are having to interact more with other practitioners in health care settings. Many of those interactions are interdisciplinary and often involve an understanding of the application of professional values and ethics. The authors have suggested that social workers' influence on ethical decision making is correlated directly to their ability to contribute to those decisions. In their study, the authors tested five independent variables and one dependent variable to show the factors that are related significantly to social workers' influence on ethical decision-making processes in multidisciplinary health care settings.     

Running on empty: health care energy use in a developing country

Health care systems require reliable energy for high-quality services. Rising fossil fuel prices globally limit the capacity of developing countries to provide continuous and essential health care services. Global health care projects should focus on energy innovation for health care use.     

Maternal drug use and the timing of prenatal care

This paper explores the role of maternal drug use and the timing of prenatal care. The study data were collected from women delivering live births at eight participating hospitals in the Washington, D.C., Metropolitan Area Drug Study. An estimated 16.9 percent of the women in this sample initiated prenatal care in their third trimester or received no prenatal care. After adjusting for age, race/ethnicity, education, parity, and attitude toward pregnancy, cocaine use was strongly associated with the timing of prenatal care. Using multivariable ordinal logistic regression, the data suggest significant barriers to prenatal care for substance abusers, especially cocaine users. Increasing access to prenatal care continues to be an important public health policy objective, particularly in urban areas where substance abuse is prevalent. Health services research must test strategies that address the timing of prenatal care among drug-dependent, urban women.     

Area-level predictors of use of prenatal care in diverse populations.

Patterns and predictors of the use of prenatal care in Hawaii were examined by census tract, taking into account summary measures of socioeconomic status, environmental conditions, and aggregated indicators of pregnancy-related risk characteristics of mothers. The objectives of the study were to identify those census tracts with high levels of inadequate use of prenatal care services; to develop a model, based on census tract characteristics, to explain observed geographic variations in the use of prenatal care services; and to identify for further investigation specific localities with unanticipated patterns of use. Data were drawn from 1980 census reports and vital statistics live birth files for the period 1979-87. Regression analysis was used to develop a model that was able to predict 61 percent of the census tract variation in the percentages of inadequate use of prenatal care services. Increased proportions of mothers of Japanese and other Asian-descent and of adults with more than high school education were associated with low levels of inadequate use of prenatal care services. Increased proportions of high parity-for-age risk and Samoan mothers were associated with higher levels of inadequate use. Census tract maps of actual and predicted percentages and studentized residual values were used to identify areas with high and low rates of inadequate use of prenatal care services. The area-level methods used are believed applicable to health care planning in other areas with ethnically or socioculturally diverse populations.