妇幼卫生扶贫基金计划可持续性发展的探讨

妇幼卫生扶贫基金计划在云南的实施将随卫 项目和“降消”项目的结束而终止。但妇幼扶贫基金计划仍有可能持续发展 ,基于政府和人民群众的意愿、国家农村卫生改革的思路、基金筹资的可能性和对基金的运行已形成的较完善的管理能力 ,建议在以后的妇幼卫生扶贫救助中 ,进一步加强宣传动员、扩宽筹资渠道、加强对基金的管理和监督、加大产前保健的扶贫覆盖面、严格把握住院补偿费用 ,使有限的卫生扶贫基金能进一步得到合理的使用     

妇幼贫困人口医疗救助项目可持续发展的研究

采用定性方法 ,研究中国南方五省市贫困地区扶贫项目实施效果的影响因素和特困人口对扶贫基金的需求状况 ,探讨我国“综合性妇幼卫生保健”项目 (卫Ⅵ )扶贫基金计划持续发展的有效途径     

江西省分宜县妇幼人口医疗救助情况调查

分宜县 1999年和 2 0 0 0年孕产妇扶贫对象覆盖率达到或超过了扶贫基金的要求 ,而 5岁以下儿童扶贫对象覆盖率偏低。该县政府对卫 项目的扶贫工作比较重视 ,扶贫基金全部由县财政解决 ,达到人均 0 .1元的筹资要求 ,扶贫基金利用率较高。分宜县孕产期保健补偿比达到 10 0 % ,其余各类服务费用补偿比也较高 ,群众对孕产妇贫困医疗救助平均补偿费用比较满意     

世界银行—云南省妇幼卫生扶贫资金研究:关键问题识别可行性研究及参与式规划

从妇幼卫生扶贫资金运作式研究设想的初步提出,到具体可行实施计划的制定,经历了4年多的复杂过程。按照关键问题识别→可行性研究→计划的逻辑顺序,对以下3个阶段进行了描述:(1)开展妇幼卫生扶贫资金项目的若干关键问题的提出;(2)经过可行性研究,提出了开展妇幼卫生扶贫资金项目的初步方案;(3)进行了参与式规划,制定了具体可行的实施计划。     

江西省卫Ⅵ扶贫项目妇幼人口医疗救助基金效果评价

为今后项目活动开展提供决策依据 ,采取问卷、访谈和文件阅读等方法 ,对 2 0 0 0年江西省的扶贫工作情况进行现场评价。结果显示 :孕产妇和 5岁以下儿童扶贫对象覆盖率分别为 4.3 %和 2 .1% ;应筹集扶贫基金 90 .81万元 ,实际筹集 3 1.0 7万元。孕产妇和 5岁以下儿童各项服务的平均补偿费用普遍高于 1999年 ;产科并发症抢救与儿童严重疾病门诊的医疗救助补偿费用所占比重最大 ,是扶贫基金关注的重点     

云南省降低孕产妇和儿童死亡率 建立综合性转诊体系的做法

云南省与加拿大合作的妇幼卫生项目 ,认真分析了 10个项目县导致孕产妇和儿童死亡的主要原因及其影响因素、危急孕产妇和儿童转诊中的薄弱环节 ,提出了从提高妇幼卫生人员知识水平和技能、制定转诊计划、建立规章制度、配备设备、社区对话及参与、扶贫基金、监督评估 7个方面建立和加强综合性转诊体系的方案。文章认为这个方案对指导边远贫困地区加强危急孕产妇和儿童的转诊工作 ,有效降低孕产妇和儿童死亡率提供了一种思路     

世界银行——云南省妇幼卫生扶贫资金研究：关键问题识别可行性研究及参与式规划

从妇幼卫生扶贫资金运作式研究设想的初步提出，到具体可行实施计划的制定，经历了4年多的复杂过程。按照关键问题识别→可行性研究→计划的逻辑顺序，对以下3个阶段进行了描述：⑴开展妇幼卫生扶贫资金项目的若干关键问题的提出；⑵经过可行性研究，提出了开展妇幼卫生扶贫资金项目的初步方案；⑶进行了参与式规划，制定了具体可行的实施计划。     

卫Ⅵ项目扶贫孕产妇医疗保健服务利用情况及影响因素分析

世界银行贷款卫 项目在改善贫困地区妇幼卫生服务提供能力的同时 ,开展了旨在提高贫困孕产妇和5岁以下儿童公平享受基本妇幼卫生服务的“医疗扶贫救助计划”。通过对卫 项目“医疗扶贫救助计划”实施 5年来扶贫孕产妇医疗保健服务利用情况的初步分析 ,找出了影响扶贫孕产妇医疗保健服务利用的主要因素 ,提出了相应的对策与建议。     

福建省全球基金艾滋病项目成效及思考

目的总结福建省全球基金艾滋病项目方法、成效与体会,为防治工作提供参考。方法对全球基金艾滋病项目的工作计划、管理方案、工作报表、专题调查、经费执行、物资管理、会议培训等资料进行总结,重点介绍项目的支持领域以及创新部分。结果全球基金项目的实施,推动了非政府组织及多部门参与艾滋病防治,探索了高危人群干预工作模式,拓展了流动人群艾滋病干预工作,进一步规范了艾滋病防治项目管理。但项目工作计划制定模式、常规工作与课题研究相结合、项目评估等有待探讨。结论全球基金艾滋病项目的经验与教训对今后艾滋病防治工作有指导意义。     

世界银行贷款卫生Ⅵ项目县特困孕产妇医疗救助费用分析

对世界银行贷款卫生Ⅵ项目部分项目县5年来特困孕产妇医疗救助于项目的费用进行了分析，主要结果如下：（1）项目改善了贫困地区孕产妇卫生服务利用的公平性；（2）应加强扶贫基金的管理和持续性；（3）项目实施过程中的信息管理有待于完善。     

Poverty, family process, and the mental health of immigrant children in Canada

OBJECTIVES: This study examined the differential effects of poverty on the mental health of foreign-born children, Canadian-born children of immigrant parents, and children of non-immigrant parents. METHODS: Secondary analysis of data from a national Canadian study of children between 4 and 11 years of age was conducted. RESULTS: Compared with their receiving-society counterparts, foreign-born children were more than twice as likely to live in poor families, but they had lower levels of emotional and behavioral problems. The effect of poverty on children's mental health among long-term immigrant and receiving-society families was indirect and primarily mediated by single-parent status, ineffective parenting, parental depression, and family dysfunction. In comparison, the mental health effect of poverty among foreign-born children could not be explained by the disadvantages that poor families often suffer. CONCLUSIONS: Poverty may represent a transient and inevitable part of the resettlement process for new immigrant families. For long-stay immigrant and receiving-society families, however, poverty probably is not part of an unfolding process; instead, it is the nadir of a cycle of disadvantage.     

参与式方法在改善生殖健康服务中的应用

为探讨在中国农村贫困地区改善生殖健康服务的有效途径 ,卫生部国外贷款办公室在福特基金的资助下 ,结合世界银行贷款卫 项目 ,开展了“改善生育卫生服务 (RHIP)”项目。 2 0 0 0年 6月～ 2 0 0 1年底在贵州省大方县将参与式方法运用到 RHIP项目中进行试点 ,包括村委会建立以“示范户”为中心的“妇女学习小组”、“男性学习小组”,以“恳谈会”开展生殖健康知识学习等。到 2 0 0 1年底 ,试点乡镇村民健康知晓率达 92 .8% ,孕产妇系统管理率达 50 .3% ,住院分娩率增幅达 1 63.7% ,已连续 2年未发生孕产妇死亡 ,到乡卫生院诊治生殖道感染的病例增加了近 1 0倍。有效地提高了村民的保健意识 ,促进其健康行为 ,大大地改善了生殖健康服务的利用状况     

Rural community women as leaders in health outreach

American's tremendous wealth and ample resources provide a myriad of opportunities for its citizens, yet children from low income, rural families face barriers that block them from enjoying those opportunities. Appalachian children face an especially acute set of problems. They are growing up in communities where entrenched poverty and unemployment have long been a fact of life and where economic forecasts remain quite bleak. Poverty is the norm. Yet even in these hard pressed communities families struggle to provide not only food and shelter, but health care, learning experiences, love and hope for their children. This article describes one example of a growing grassroots movement that relies on the energy and talents of rural women to support families coping with the damaging effects that poverty has on family life.The work described in this paper was supported by the Ford and Robert Wood Johnson Foundations.     

The effects of poverty, race, and family structure on US children's health: data from the NHIS, 1978 through 1980 and 1989 through 1991.

OBJECTIVES: This study investigated the independent and relative effects of family structure, race, and poverty on the health of US children and youth under 20 years of age at two time periods, 1978 through 1980 and 1989 through 1991. METHODS: Data were from the National Health Interview Surveys. Multivariate logit regression methods were used to analyze the effects of family structure, poverty, and race on children's health. RESULTS: Children in families headed by single mothers, Black children, and those living below 150% of the poverty index were much more likely to be in poor or fair health than children in two-parent families, White children, or those in more affluent families. Poverty had the strongest effect on child health in both time periods. CONCLUSIONS: The association between children's health and living below 150% of the poverty index is not explained by race or family structure. The disparity in child health by family income has serious consequences for both the child and society.     

世界银行—云南省妇幼卫生扶贫资金服务的利用

分析,比较了世界银行－云南省妇幼夫贫资金项目实施前后1年间,3个经济水平组常规孕产妇保健服务的利用情况,结果显示：妇幼卫生扶贫资金促进了特困,次贫困家庭（南润）的孕产妇对常规孕产妇保健服务的利用,提高了其对服务的利用率。     

Poverty,social exclusion and health in Portugal

People in Portugal have never been so healthy. Nevertheless, there are great differences in health status between social groups and regions. In 1994, Portugal was the country with the second worst level of inequality in terms of income distribution and with the highest level of poverty in the European Union (EU). Poverty in Portugal affects mainly the elderly and women (especially in single parent families). Beyond these groups, there are the children, the ethnic minorities and the homeless. Substance abusers, the unemployed, and ex-prisoners are also strongly affected by situations of social exclusion and poverty. Although poverty has been an important issue on the political agenda in Portugal, it shows a worrying tendency to resist traditional Social Security interventions. In the late 1990s, however, welfare coverage rates appear to have risen. To what extent can poverty cause a worsening of health status? Is there any sustainable positive association between welfare and improved health status? How, to whom and when should actions to improve the health status of the disadvantaged be addressed, without subverting the health status of the rest of the population. It is also necessary to reveal the consequences of poor health to individuals, families and communities in terms of income, social empowerment and the ability to fulfil other needs. Finally, reflection on the role and effectiveness of traditional social security models is necessary, in order to improve the impact and adequacy of its interventions. The goal of this paper is to contribute to the knowledge about disadvantage, the current health situation of the most vulnerable groups in Portuguese society-those affected by poverty, deprivation and social exclusion-and to detect the constraints on access to health and health care.     

世界银行—云南省妇幼卫生扶贫资金项目服务公平性的效果分析

目的：以住院分娩服务为例,分析妇幼卫生扶贫资金项目对卫生服务利用公平性改善的情况,结果：对照县的孕产妇利用住院分娩服务的集中指数为0．0215,实验县为0．0001,可近似等于0,表明实验县不同经济组的孕产妇利用住院分娩的服务是完全公平的,妇幼卫生扶贫资金确实改变了贫困农村妇女对柱院分娩服务利用的公平性。     

城市贫困及弱势人群卫生服务利用及其影响因素研究

讨论影响城市贫困及弱势人群的社区卫生服务的主要因素及解决这一问题的途径。目前城市中的生活贫困者主要是下岗、失业以及退休等原因所致。贫困使他们的健康状况较差 ,对卫生服务利用水平低。政府和医疗卫生部门应该全面认识解决这一问题的重要性 ,采取必要而有效的措施 ,提高城市中该群体的整体生活水平 ,从而提高他们对社区卫生服务的利用 ,改善他们的健康状况     

Making poverty a practice issue

Trends in poverty and changes in service provision are combining to make the promotion of health in poverty a particular challenge to health and welfare practitioners. The evidence suggests that practitioner groups have failed to respond adequately to this challenge. Factors concerned with professional perceptions of poverty, the nature of qualifying and post-qualifying education and the difficulties associated with taking research into practice all appear, in some way, to contribute to practitioners’ failure to incorporate a poverty perspective in their work. A team training approach appears to offer one way forward in the practice-setting. Using a team training approach, the‘Health Promotion in Poverty Project’ has sought to enable the lessons learnt from the broad base of poverty theory and research to be used by practitioners to build responsive and integrated support strategies for low-income families with dependent children.     

Poverty, Tobacco, and Health: An Indian Scenario

Poverty and health have a two-way relationship. Poverty increases the vulnerability of people to disease, and sickness affects their income leading to poverty. Tobacco has been identified as a major avoidable cause of illness and premature death. In India, more than half of men and one-tenth of women use one or more forms of tobacco. Tobacco-use shows a clear and continual increase with decreasing wealth quintiles. Poor smokers, who are at a greater risk of illness, are also at a greater risk of not being treated or of falling into greater poverty if they seek treatment. Poor people spend money on tobacco that could be spent on food, shelter, education, and healthcare. These decisions can entrench families in an ongoing cycle of poverty and ill-health. The direct and indirect costs of tobacco-use are immense for national economy. This has positioned control of tobacco relevant in India''s per suite to achieve the goals of poverty eradication and health for all.Key words: Health, Poverty, Tobacco-use, India