谈改进市级妇幼保健教育的几种方法

本文就如何尽快改变妇幼保健人员素质与工作要求不相适应,领导对妇幼工作重视不够,群众自我保健意识缺乏的状况,介绍了邯郸市近年来所采取的几种培训方法.具体做法是:定期编写、发放保健工作手册,借助现有医学教育部门培训保健专业人员,端正保健院工作方向,加强职业道德教育,加强部门联合,搞好横向培训.     

县、乡两级妇幼卫生与计划生育服务体系整合研究——以湖北省崇阳县为例

目的:以湖北省崇阳县为例,描述妇幼卫生与计划生育服务体系整合的方式,分析关键要素,为推进整合提供借鉴和参考.方法:运用定性访谈、问卷调查等方法收集资料;采用QSR Nvivo 8.0软件及SPSS 17.0软件进行定性和定量资料的分析.结果:崇阳县充分认识到整合的重要性,积极落实配套政策,保持原有补偿方式不变、不减编不减员,迅速推进了机构合并,合理调整服务内容和方式,并整合了妇幼与计生信息平台.结论:对整合的正确认识、稳妥的人事制度及稳定的经费支持有力地推动了整合工作的落实,但未来在人员编制管理、激励机制、服务内容及形式等方面仍需进一步的探索和创新.     

甘肃省静宁县实施母子系统保健项目效果分析

目的评价甘肃省静宁县母子系统保健项目工作实施效果。方法收集该县24个乡镇2005—2011年的妇幼年度报表进行统计、分析。结论通过母子系统保健项目的实施,有效提高了该县孕产妇和儿童健康水平,同时卫生服务提供和服务利用水平也有一定提高,为今后妇幼卫生工作的开展打下了坚实的基础。     

An investment case for maternal and neonatal tetanus elimination

IntroductionGlobally, 13 countries have yet to eliminate maternal and neonatal tetanus. While efforts have improved access to tetanus toxoid containing vaccines (TTCVs) and increased clean delivery practices, reaching elimination targets (<1 case of neonatal tetanus per 1000 live births per district per year) may require significant resources to reach the remaining high risk and hard-to-reach districts.MethodsWe estimated the cost to achieve maternal and neonatal tetanus elimination (MNTE) in three years in the remaining 13 countries: Afghanistan, Angola, Central African Republic, Democratic Republic of the Congo, Guinea, Mali, Nigeria, Pakistan, Papua New Guinea, Somalia, South Sudan, Sudan, and Yemen. Costs were estimated for: (1) vaccination campaigns using standard TTCVs and TT-Uniject™ targeting women of reproductive age in high risk areas, (2) additional vaccinations delivered to pregnant women at antenatal care (ANC) clinics, (3) clean delivery and umbilical cord care promotion, (4) neonatal tetanus surveillance strengthening, and (5) validation activities. We forecasted the averted mortality to assess the cost-effectiveness of achieving MNTE.ResultsIt will cost an estimated US$197.7 million to realize MNTE over three years. These costs include $161.4 million for vaccination campaigns, $6.1 million for routine vaccination during ANC, $23.3 million for promotion of clean delivery practices, $4 million for surveillance, and $3 million for validation of MNTE. Achieving MNTE will avert approximately 70,000 neonatal deaths over ten years of vaccine protection, resulting in approximately 4.4 million life years gained. It will cost $2,900 per death averted and $45 per life year gained.ConclusionMaternal and neonatal tetanus can be eliminated with significant financial investment, high prioritization, and strong political will. While substantial costs must be incurred to reach hard-to-reach populations, MNTE should be accomplished as a matter of health equity, and will significantly contribute to reaching the United Nations' Sustainable Development Goals.     

海南省2005～2010年围产儿死亡率及相关因素分析

目的:分析海南省围产儿出生缺陷的基本情况及动态变化,探索影响围产儿出生缺陷的原因及预防策略。方法:对2005～2010年海南省某妇幼保健院出生缺陷围产儿的资料进行统计分析。结果:11 483例围产儿中发生出生缺陷286例,出生缺陷发生率为24.91‰;出生缺陷儿死亡率为3.57‰。出生缺陷前5位疾病是:唇腭裂、多指畸形、外耳畸形、先天性心脏病、神经管发育畸形;出生缺陷发生率与孕产妇年龄呈正相关,年龄35岁以上是发生出生缺陷的高危因素;分娩出生缺陷新生儿的孕妇以城乡低收入、低文化人群为主。结论:加强育龄孕妇产前筛查和优生优育教育,营造优生优育的社会和文化环境,降低婴儿出生缺陷的发生率。     

加强常州地区妇幼卫生保健工作的政策研究

该文旨在研究如何进一步加强和改进常州地区妇幼保健工作。研究将常州妇幼保健工作可能存在难点归纳为八个方面，通过文献归纳和专家资源构建调查表，调查了从事妇幼保健工作领域99人，通过意向分析明确了常州地区妇幼保健工作存在的主要难点，以及进一步加强妇幼保健工作所需前提条件和政策措施。     

抓住机遇 增强活力 走妇幼保健院加速发展之路

<正> 妇幼卫生随着社会的不断进步和医学模式的转变,已逐步发展成为卫生事业中不可替代的,与医疗、预防并驾齐驱的独立体系。如何加强县(市)级妇幼保健机构建设,充分发挥妇幼保健中心作用,组织实施辖区内妇幼保健工作规划,检查、督促基层各项妇幼保健任务的落实,指导基层采取新技术、新方法等干预措施,笔者就萧山市妇幼保健院抓住有利机遇,突出保健特色,探索符合县(市)级     

Womb at work: The missing impact of maternal employment on newborn health

Parental leave policies across the globe have become much more generous than they used to be. This is also true for prenatal maternal leave. While this may be costly in the short run, little is known about the effect of maternal employment during pregnancy on newborn health. In this paper, I exploit three sharp policy changes on the duration of paid parental leave in Austria that strongly affected the share of mothers who work up to the 32nd week of pregnancy. I use administrative data from Austria on the working history of women linked to the full Austrian birth register and coupled with a regression discontinuity framework to identify the effect of prenatal employment on their offspring. Maternal employment during pregnancy with the second child reacts strongly to these policy changes. The share of employed mothers sharply declined in 1990 by 19.1 percentage points, increased in 1996 by 6.9 percentage points and declined again by 6.4 percentage points in 2000. None of these changes in prenatal employment translated into effects on newborn health measured via birth weight, gestational length, and Apgar scores. This result holds true for mothers of different socioeconomic backgrounds and across industries. The effect is precisely estimated, which suggests that prenatal employment prior to the 32nd week of pregnancy does not causally affect the fetus for measures visible at birth.     

Challenges to the reproductive-health needs of African women: on religion and maternal health utilization in Ghana

How relevant is religion to our understanding of maternal health (MH) service utilization in sub-Saharan Africa? We ask this question mainly because while the effect of religion on some aspects of reproductive behavior (e.g., fertility, contraception) has not gone unnoticed in the region, very few studies have examined the possible link with MH service utilization. Understanding this link in the context of sub-Saharan Africa is particularly relevant given the overriding influence of religion on the social fabric of Africans and the unacceptably high levels of maternal mortality in the region. As African countries struggle to achieve their stipulated reductions in maternal and child mortality levels by two-thirds by 2015 as part of the Millennium Development Goals, the need to examine the complex set of macro- and micro-factors that affect maternal and child health in the region cannot be underestimated. Using data from the 2003 Ghana Demographic Survey, we found religion (measured by denominational affiliation) to be a significant factor in MH use. This is true even after we had controlled for socio-economic variables. In general, Moslem and traditional women were less likely to use such services compared with Christians. The findings are discussed with reference to our theoretical framework and some policy issues are highlighted.     

天津市2005年妇幼卫生费用研究

目的为了提高天津市妇幼卫生人群服务利用的可及性和健康公平,为政府决策部门提供妇幼卫生经费投入的科学数据。方法以功能法为核心,结合筹资法和机构法测算结果进行妇幼卫生费用的矩阵平衡分析。结果 2005年天津市妇幼卫生服务筹资以社会及个人筹资为主,占80.81%;妇幼保健机构的妇幼卫生服务总收入小于总支出,为收不抵支状况;收大于支服务项目以含有临床技术项目为主。结论应积极探索政府卫生经费投入方式,逐步量化公共卫生服务项目费用和投入,提高政府卫生资金的使用效率。     

探究式教学在妇幼与青少年健康课程教学中的实践

探究式教学是指教学过程中,学生在教师的指导下,通过以“自主、探究、合作”为特征的学习方式对教学内容中的主要知识点进行学习、深入探究,并进行小组合作交流,从而较好地达到教学目标的一种教学模式。本研究依托四川大学课程中心的网络学习平台,将探究式教学作为传统教学模式的有力补充,融入师生学习共同体的理念,倡导多元化的师生互动模式,对探究式教学在妇幼与青少年健康课程教学中的实践应用进行了探索。     

四川省妇幼保健机构等级评审结果分析

目的:了解和分析四川省妇幼保健院机构管理和临床、保健管理方面现状。方法:组织专家按照统一的评审标准对申请评审机构进行评审,对机构管理、保健管理和临床管理评审得分情况结合专家评审报告进行分析。结果:机构管理方面业务用房面积、实有床位数和卫生专业人员数与标准的差距较大,科教管理得分率较低;二、三级妇幼保健院保健管理平均得分率分别为92.0%和88.8%,相关内容从高到低依次为:公共卫生、妇女保健和儿童保健;临床管理平均得分率分别为89.53%和84.19%,其中二级妇幼保健院医院感染管理和药事管理得分率较低,而三级乙等妇幼保健院医学影像得分率最低。结论:等级评审促进了妇幼保健院的建设和发展,但普遍在硬件及人才队伍建设、科研工作、医疗保健亚专业发展、医院感染管理和医疗质量管理以及辅助科室服务能力方面还亟待提高。     

围生期健康教育对初产妇保健状况的影响

目的 探讨围生期健康教育对初产妇保健状况的影响.方法 将在北京市大兴区兴丰街道社区卫生服务中心建档的无孕产史的孕妇160例随机分成观察组和对照组,每组80例.对照组给予常规性健康教育,观察组给予多种方式的健康教育,比较2组产妇对围生期保健认知行为、分娩方式、分娩后并发症等情况.结果 观察组孕妇围生期保健认知行为掌握比例高于对照组(P＜0.05),观察组产妇自然顺产比例高于对照组(P＜0.01);且自然顺产产妇平均产程短于对照组(P＜0.05);观察组产妇在宫缩乏力、产前抑郁、产后抑郁、产后泌尿道感染、产后排便困难、产后排尿困难方面得到了改善,发生率低于对照组(P＜0.05);胎儿窘迫、新生儿窒息、巨大儿的发生率明显降低(P＜0.05);母乳喂养比例明显高于对照组(P＜0.05).结论 围生期健康教育可以大大提高初产妇保健知识的掌握程度,提高产妇及胎儿、新生儿的健康,降低产前和产后孕妇并发症的发生.     

妇幼保健院集团化建设的思考

我国医疗保健市场竞争日趋激烈,妇幼保健机构面临双重压力的考验:一方面其本身存在着投资少、规模小、设备落后、人才技术缺乏、先天禀赋不足的问题;另一方面医疗机构的迅猛发展和扩张,对市场空间的挤占,使得它更显得弱小和单薄。为了寻求生存和发展,适应市场的竞争,妇幼保健机构应该走集团化发展的道路。此研究分析了妇幼保健机构面临的形势,提出了走集团化发展道路的优势,并就如何推进妇幼保健机构集团化建设提出了设想。     

广州市荔湾区社区妇幼保健服务资源现状分析

目的:了解并评价广州市荔湾区22个社区卫生服务中心妇幼保健服务资源的现状。方法:设计自填式问卷,对22个社区卫生服务中心的妇幼保健服务情况进行横断面调查。结果:社区卫生服务中心妇幼保健网络健全,人员、场地、设备、服务项目能满足妇幼人群的基本需求,但社区妇幼保健服务比较局限,设备设施、人员素质有待进一步的改善和提高。结论:改善社区卫生服务中心妇幼保健工作设备设施,提高妇幼保健人员素质和服务质量,以利于提升社区妇幼保健服务的整体水平。     

长沙市9所妇幼保健机构人力资源现状调查分析

目的:了解长沙市县区级2013年妇幼保健机构人力资源状况及存在问题,为卫生与计生合并完善区域妇幼保健机构人力资源管理提供数据.方法:采用统一的“全国妇幼卫生服务资源调查表”,对长沙县区妇幼保健机构的妇幼保健人力资源进行调查和描述性分析.结果:区域妇幼保健人力资源配置总体不足,学历职称偏低.结论:可尝试在卫生与计生合并时制定相应政策与资金投入,加快区域妇幼保健队伍建设与能力提升.     

山东和宁夏新型农村合作医疗对妇幼卫生服务的影响

目的:分析山东和宁夏新型农村合作医疗对妇幼卫生服务的影响。方法:分层随机抽样,用定量与定性相结合的方法分析山东和宁夏新型农村合作医疗对妇幼卫生服务的影响。结果:妇幼卫生服务利用得到改善,但新农合对减轻妇女儿童疾病经济负担的作用有限。新农合实施后农民的保健意识和就医行为有所改善;对住院分娩率基础较差地区的促进作用明显;对产前检查和产后访视服务利用的促进作用不明显。结论:新农合对妇幼卫生服务有一定影响,但效果不明显。     

A community survey on maternal and child health services utilization in rural Ethiopia

A household health interview survey on MCH services utilization was carried out in 22 villages of a rural district of Arsi region, Ethiopia, before the launching of an integrated MCH programme. Coverage of antenatal services was 26%, and 61% of the women who received antenatal care reported having had 3 or more visits.Antenatal care was positively associated with living within 10 km of the Health Centre. Twenty-eight percent of the mothers attended the under-5 clinic and most returned for 3 or more visits. In addition, 99% reported having breast-fed their last child but more than 25% started weaning only after the seventh month of age. Differences in practice of treating diarrhoea according to knowledge of ORS were found. Of the 33% of those with knowledge of ORS, almost 90% reported use of ORS for treating child's dirrhoea, showing a positive attitude towards modern health care. The proportion of women using family planning was 5%, with no difference found between Christians and Muslims. Results on EPI coverage validated data from routine reporting. Integration of MCH services including out-reach activities may increase access and coverage of MCH services.     

县级妇幼保健机构如何适应市场经济的发展

<正> 面对市场经济的不断发展,妇幼卫生机构必须转变观念,深化改革,主动适应市场经济要求。那么,这条路应当怎么走?1 坚持以保健为中心,完善服务体系适应市场经济不是说什么都要以经济效益来衡量。妇幼卫生毕竟是公益性的福利事业,因此要坚持以保健为中心,以基层为重点,首先满足群众的基本保健需求。近几年推行的保健保偿服务,是一种适合农村基层保健的好办法,要继续完善,进一步加强管理。     

苏州市妇幼卫生信息化建设实践与探索

目的介绍苏州市妇幼卫生信息平台建设情况,探讨利用信息化提高妇幼健康服务于管理水平的方法。方法应用计算机、互联网技术,建设基于区域卫生信息平台的妇幼卫生信息系统,实时采集婚前保健、孕前保健、围产保健及儿童保健的健康信息,对妇女儿童健康状况实时监测和管理。结论妇幼卫生信息化建设是妇幼健康事业发展的必然趋势,信息化提高了妇幼健康管理水平,提高了管理的时效性、准确性和决策的科学性。