健康教育在农村卫生保健中的作用

江苏省江宁县自１９９１年起实施农村初级卫生保健８年来所取得的成绩,可总结为全民健康教育工作,不仅是初级卫生保健的基本内容,而且是农村实施初级卫生保健成败的至关重要的先决条件之一。１、健康教育是实施农村初级卫生保健的基本内容　利用电视、广播、报纸、专栏、黑板报、培训班,咨询以及发放卫生科普知识材料等多种形式,把卫生防病和保健知识传授给农村居民。８年来,江宁县农村中小学生卫生知识知晓率和卫生行为形成率已从１９９０年不足３０％到１９９８年分别至９０％和８０％以上,农民的卫生知识知晓率和卫生行为形成率也…     

初级卫生保健与农村居民健康促进

农村的初级卫生保健(PrimaryHealthCare,简称PHC)是农村居民应该人人享有的,与农村经济社会发展相适应的基本卫生保健服务。实施农村初级卫生保健是我国社会经济发展总体目标的组成部分,是各级政府的重要职责。经过努力,我国农村已基本实现了1990-2000年初级卫生保健阶段目标。然而,由于各地经济发展的不平衡,各地群众享受的初级卫生保健服务水平高低不一,保健项目的开展也各有差异。理论上,初级卫生保健从受益来说是每个人都能享受的,从需要来说是必不可少的,是一种最能体现社会平等权利的卫生保健措施;因此各地初保工作发展的不平衡同…     

四川省民族地区初级眼保健评价标准

我国农村实现人人享有卫生保健的基本策略是在全体农村居民中实施初级卫生保健,而初级眼保健是初级卫生保健的一项重要内容。1991年四川省正式将初级眼保健纳入初级卫生保健规划,并制定了《四川省2000年防盲及初级眼保健规划》。为实现规划目标,必     

社区环境与村医疗点业务收入关系的研究

世界卫生组织(WHO)在1998年第51届世界卫生大会上提出:21世纪人人享有初级卫生保健的目的,在于继续实现1978年阿拉木图会议发起的人人享有卫生保健的理想。并确定了21世纪人人享有卫生保健的总目标和具体目标。我国农村初级卫生保健工作的进一步落实要依靠三级卫生服务网,其中作为网底的村级卫生组织是初级卫生保健的主体,是切实保障全体农村居民享受基本卫生服务、实现2000年全球卫生目标和我国2010年第二个初级卫生保健十年规划目标的关键。     

如何制订农村初级卫生保健技术岗位培训的计划

农村初级卫生保健技术人员的素质不高严重影响到初级卫生保健工作的水平.要提高农村初级卫生保健工作的水平必须从源头抓起,即:开展初级卫生保健技术岗位培训.制订切实有效的培训计划是做好培训工作的关键环节.该文就制订培训计划应该遵循的基本原则和制订培训计划的步骤、方法作一探讨,旨在规范初级卫生保健技术岗位培训和提高培训效果,使有限的培训资源发挥更大的培训效用,进而提高农民卫生服务的质量和水平.     

中国农村初级卫生保健发展纲要(2001年～2010年)

农村初级卫生保健(以下简称初保，英文名Primary Health Care，英文简称PHC)是农村居民应该人人享有的，与农村经济社会发展相适应的基本卫生保健服务。实施农村初保是我国……     

第四讲 农村初级卫生保健

初级卫生保健是乡镇卫生院的中心工作。乡镇卫生院的固有名称之所以称为“卫生院”而不称“医院”,因为其功能与任务不仅仅是为农村居民提供基本的医疗服务,还应开展预防保健和各项社会卫生工作(如普及健康教育、指导农村改水改厕等)以及管理乡镇范围内的卫生行政工作。而这些都属于农村初级卫生保健工作的范畴。因此,乡镇卫生院的中心工作应当围绕全面实施初级卫生保健而展开。作为乡镇卫生院院长的刊授课程,这一讲,将系统介绍农村初级卫生保健的理论、政策和乡镇开展初级卫生保健的工作方法。1　初级卫生保健的基本概念和内容1.1　初级卫…     

谈乡镇政府与初级卫生保健

实施初级卫生保健是实现“2000年人人享有卫生保健”战略目标的关键,我国有80％的农村人口,在农村开展初级卫生保健,增进和改善农村居民的身心健康是我国卫生工作的重点。下面笔者仅就乡镇人民政府如何参与初级卫生保健谈谈自己的看法。     

我国农村实施初级卫生保健的战略与措施

我国有11亿人口，8亿人居住在农村地区，为实现人人享有卫生保健的全球目标，我国始终把在全体农村居民中实施初级卫生保健作为基本的策略和途径。卫生部从中国农村的实际出发，参照世界卫生组织的全球性指标，组织制定了我国农村实现2000年人人享有卫生保健的规划目标，并提出了分层次、分地区、分阶段全面地实施初级卫生保健的构想。本文在此基础上，介绍了我国农村实施初级卫生保健的战略与具体措施。     

农村初级卫生保健理论研究的新进展

随着我国农村初级卫生保健工作的深入普及,有关初级卫生保健的理论研究工作呈现出可喜的局面。1992年是我国建国40余年以来,农村卫生和初级卫生保健理论研究跃上新台阶的一年,主要为:①初级卫生保健管理的研究;②世界卫生组织中国农村初级卫生保健合作中心十年工作经验的理论总结;③实施初级卫生保健适宜技术与基本药物的研究。在以上几方面研究的基础上,正式编辑出版了《初级卫生保健管理》、《中国农村初级卫生保健指导手册》、《初级卫生保健在中国——中国农村世界卫生组织初级卫生保健合作中心资料汇编》和《中国农村初级卫生保健适宜技术与基本药物手册》,受到了国内外卫生界的瞩目。     

Rural general practice: a personal view of current key issues

We know much less about health care needs and provision in rural areas than we do about urban areas, particularly the inner cities. Although rural areas are attractive, isolation and lack of accessible services create problems for residents, particularly for those without transport. Analysis of the problems is handicapped by the lack of generally acceptable definitions of the meaning of rurality and remoteness. Rural deprivation is not reflected in commonly used indices of deprivation and is often "hidden". There is a shortage of general practitioners and concern that the situation is deteriorating. What does this mean for the future? Should there be a 'rural track' in educational programmes for rural health workers? How can we harness telemedicine to improve communication between rural dwellers and primary health care, and between primary and secondary health care? Where will nurse practitioners fit into the picture? If centralised services (e.g. for accident and emergency) lead to higher quality of care, how can rural dwellers have equitable access? Some possible solutions are presented.     

加强农村卫生服务体系建设 促进人人享有基本卫生保健

建立国家基本卫生制度、实现人人享有基本卫生保健是国际社会＂全民健康覆盖＂目标的具体体现。过去几十年,江苏省农村卫生服务体系得到了较好发展,基本建立具有较高可及性的农村服务组织网络,为实现农村居民人人享有基本卫生保健打下了良好的基础,同时还存在诸多亟待解决的问题。为此提出建议：明确政府健康责任,改革卫生投入机制;优化卫生服务体系布局,提高高质量卫生服务的可及性;加强基层卫生人才队伍建设,提高基本卫生服务质量;完善薪酬分配制度,调动卫生人员积极性。     

Toward a Rural Health Corps Concept: Lessons from the Dominican Republic*

ABSTRACT: In recent years, primary health care services have expanded rapidly in rural Latin America. However, these services are characterized in many countries of the region by inefficiency and low quality. Research on rural health services in the Dominican Republic identifies the compulsory year of rural service required of graduating medical students (known as pasantia in some countries and medicatura rural in others) as one of the main causes for these problems. Conflicting roles assigned to rural health promoters by the ministry of health and by rural residents are another contributing factor. The manner in which these characteristics of the rural health system reduce the productivity of health resources and the quality of care is discussed. The authors suggest that the organization of a rural health corps could resolve the main flaws inherent in the use of the pasantia and strengthen the work of the promoters.     

中国农村基层医疗卫生服务质量评价——需方角度

采用2008年国家卫生服务调查的数据,从需方角度,通过利用者感知质量对我国农村基层医疗卫生服务质量进行了评价。结果表明:影响农村居民对基层医疗服务的感知质量和利用水平的原因主要在于相对于其经济承受能力较高的医疗费用、基层医疗机构较差的设备环境和偏低的技术水平等。建议:一是农村基层医疗卫生机构围绕改善设备环境、提高收费的合理性和提高医务人员技术水平等加强医疗服务质量建设。二是进一步完善农村居民医疗保障制度,将农村基层医疗卫生机构服务项目纳入保障范围,并适当提高补偿水平。     

Provision of health care in rural Afghanistan: needs and challenges

Afghanistan's health system is severely limited in terms of preventive and curative services, referral systems, and human resources. Most of the country's citizens reside in rural areas, a majority of which are served by "basic health units" (small and simple facilities that provide primary care), and these rural residents face additional challenges regarding timely access to quality health care. The analysis described in this article, which focuses on data derived from 2 rural health units during a 1-year period, revealed that infectious diseases, mainly acute respiratory infections, were a primary concern and that there is a clear need for increasing access to health services. In addition, our results showed that women are underrepresented as patients and appear to be at higher risk than men of tuberculosis.     

Accessibility and Perceived Value of Health Services in Five Western Illinois Rural Communities

The purpose of this study was to determine the accessibility and perceived value of health services in five selected rural communities in South Fulton County, Illinois. The Health Services Accessibility and Value Scale (HSAVS) component of the larger Fulton County Health Care Survey was used in the investigation. The 12 items comprising the HSAVS surveyed participant perceptions relative to medical, dental, nursing, and public health department services available to them as rural residents. The HSAVS was completed by 1079 subjects. The reliability of the HSAVS was assessed by computing coefficient alpha. The scale had acceptable internal consistency reliability (alpha = .7884). To examine the construct validity of the scale, a principle component factor analysis was completed. This analysis resulted in a four factor solution which accounted for 66.6% of the cumulative total variance. Item means were calculated and were used to rank the HSAVS statements. Emergency and primary medical services were valued the most by the survey participants. Relatively high in importance to the rural residents surveyed were access to pharmacy, eye care, dental care, and immunization services. Availability of home health care, transportation to and from health care facilities, and access to mental health services were considered to be of lesser value to persons living in the rural area studied. Of least importance were alcohol and other drug counseling services, prenatal care/well baby services, and family planning services. HSAVS total scores and individual statements were also analyzed by sex, age, place of residence, and income and the results were reported.     

Evaluating the impact of sustainable comprehensive primary health care on rural health

Objective: To develop a conceptual framework for monitoring the relationship between health services and health outcomes in rural Australia. Design and setting: Development of an evaluation framework for a rural comprehensive primary health service in Victoria. Results: Evidence regarding essential components for successful primary health care, and objective health service and health status measures were combined to develop a conceptual health service evaluation framework. Application of the framework is illustrated using a case study of a rural primary health service in Victoria. Conclusions: Inadequate health services limit access to health care, delay use at times of need and result in poor health outcomes. Currently, there is a lack of evidence from rigorous health service evaluations to indicate which rural health services work well, where and why that could inform rural health policies and funding. Although the nature of health service models will vary across communities in order to meet their differing geographic circumstances, there is considerable scope for the translation and generalisation of evidence gained from health service models that are shown to be sustainable, responsive and able to deliver local quality health care. This framework can guide future health service evaluation research and thereby provide a better understanding of a health service's impact on the health of the community and its residents.     

农村基层医疗卫生机构视力检查服务提供与利用

目的:分析农村基层医疗卫生机构视力检查服务的可及性对居民视力检查服务利用的影响。方法:利用医疗卫生机构和农户调查数据,采用描述统计和多元回归分析。结果:样本中33.2%的居民自报告视力不良,22.1%的居民曾做过视力检查,86%样本乡镇的卫生院和44%样本村的村卫生室可以提供视力检查服务;回归结果显示,乡镇卫生院提供视力检查服务将显著增加居民进行视力检查的可能性,但村卫生室是否提供视力检查服务对居民视力检查的利用没有显著影响。结论:农村居民对视力检查服务需求很大,但是利用率低。基层医疗卫生机构服务供给不足可能是导致农村居民服务利用率低的重要因素。建议国家继续推进基本公共卫生服务,加强基层医疗卫生服务机构开展基本视力检查的能力,促进农村居民对视力检查服务的利用,改善农村居民视力健康水平。     

兰州市城乡居民精神卫生知识知晓率调查与分析

目的：调查兰州市城乡居民对精神卫生知识的掌握程度,进一步提高大众对精神卫生知识的知晓率,更好地预防和控制精神疾患的发生,降低精神患者肇事肇祸的风险。方法采用分层整群随机抽样法,抽取兰州市18岁及以上的常住人口城市居民785人和农村居民741人,调查内容为卫生部办公厅2010年关于精神卫生工作指标调查评估方案的问卷之一,实际调查城市居民688名,农村居民674名。比较城市居民与农村居民对精神卫生知识的知晓程度并进行相关分析。结果本次调查中,兰州市城乡居民精神卫生知识平均知晓率为59．0％,其中城市居民为63．4％,农村居民为54．6％。城市居民精神卫生知识知晓率高于农村居民。回答正确率较低的条目主要集中在精神疾病的病因、预防、长期服药以及重大精神卫生纪念日方面。结论兰州市城乡居民精神卫生知识知晓率较低,未达到国家精神卫生工作纲要的要求,今后需继续加强精神卫生知识的宣传和教育。     

农村卫生服务公平性与可及性的盲区研究:以山西省太谷县为例

通过调查发现山区农民、严重慢性病人、重度残疾人、进城农民工以及社会流浪人等是农村卫生服务公平性与可及性的主要盲区人群。解决盲区人群的医疗卫生服务困难的关键是要尽快恢复农村卫生服务的公益性,完善农村医疗服务体系和健康保障体系,提高盲区人群抵抗疾病风险的能力。