加强计t划生育技术服务机构能力建设的调查

为配合<计划生育技术服务管理条例>的贯彻实施,加强计划生育技术服务能力的建设,我们利用国家计划生育委员会举办的"第二期地市级计生干部学习<计划生育技术服务管理条例>培训班",对学员进行了调查.调查发现,现有县乡级机构技术服务能力仍有明显不足,尤其在乡级单位最为明显.主要表现为有资格的技术服务人员和设备器材的缺乏以及服务项目的不足,且东、西部省份间存在明显差异.建议抓好技术服务人员的全面培训;规范乡级技术服务机构的服务项目和范围;保证各级政府部门对计划生育事业的财政投入和改进现行的不相适应的考核制度.     

云南和安徽两省县、乡计划生育机构宫内节育器放置人员工作满意度差异分析

目的:了解云南和安徽两省县、乡计划生育机构宫内节育器(IUD)放置人员工作满意度及其差异。方法:采用JSS工作满意度量表对县、乡计划生育服务机构496名IUD放置人员进行问卷调查并作统计分析。结果:县、乡计划生育机构IUD放置人员工作满意度得分为142.4±24.1,不同维度中得分较高项包括领导、沟通和同事满意度;较低项包括薪酬、晋升和福利。县级IUD放置人员工作满意度要高于乡级,主要表现在晋升、领导、回报、同事、工作性质、工作流程等方面。多因素回归分析显示县级IUD放置人员工作满意度主要受年龄、教育程度、执业类型和近5年培训次数影响;而乡级IUD放置人员主要受教育程度、职称和从事IUD放置工作年限影响。结论:县级计划生育服务机构IUD放置人员工作满意度高于乡级计划生育服务机构,人才结构及其工作环境是差异的主要原因。     

避孕节育知情选择规范

<正> 2001年12月颁布的《中华人民共和国人口与计划生育法》明确规定“国家创造条件,保障公民知情选择安全、有效、适宜的避孕节育措施”。“各级人民政府应当采取措施,保障公民享有计划生育技术服务,提高公民的生殖健康水平”。《计划生育技术服务管理条例》也明确规定,“计划生育技术服务实行国家指导和群众自愿相结合的原则。公民享有避孕方法的知情选择权。国家保障公民获得适宜的计划生育技术服务的权利”。所有的计划生育服务机构都必须严格执行《人口与计划生育法》及《条例》的各项规定,积极稳步推进知情选择。为了使避孕节育知情选择在全国范围内有效地实施,特制订本规范。     

上海市流动人口孕产妇平产分娩点医院避孕服务状况调查

目的:了解流动人口孕产妇平产分娩点计划生育和避孕咨询服务现状及医务人员的产后避孕知识。方法:通过结构式问卷,对2004年上海市卫生局设立的10家流动人口孕产妇平产分娩点医疗机构进行机构设置及避孕服务调查,对机构中涉及到计划生育/避孕咨询服务的医务人员进行产后避孕知识调查。结果:10家外来人口分娩点医院中,仅有3家医院设有独立的计划生育门诊,8家医院设有计划生育咨询室,所有的二级医院均设有计划生育病床,平均提供10.5种避孕方法的咨询,可以操作落实的避孕服务项目平均为7.1种。343名调查对象中,279人(80.8%)曾为孕妇或产后妇女提供过避孕咨询服务;109人(31.8%)曾参加过计划生育/避孕咨询方面的培训。产后避孕知识得分最高为82分,中位得分为34分;多因素分析显示,调整其他可能的影响因素后,培训是影响医务人员产后避孕知识最重要的因素。结论:大部分流动人口孕产妇平产分娩点机构的计划生育设置和避孕方法咨询服务能够达到管理文件要求。但仍需加强计划生育门诊的硬件建设和针对性地加强医务人员产后避孕知识的再培训,更新知识结构。     

贯彻技术服务管理条例 推进避孕节育知情选择

《计划生育技术服务管理条例》的颁布与实施将推动避孕节育知情选择在中国的深入开展 ,有效推进知情选择将成为贯彻实施条例的关键。本文系统阐述了避孕节育知情选择的起源、发展和背景 ,影响避孕方法选择的因素 ,开展知情选择的策略 ,政府计划生育部门及社会团体各界的职责 ,知情选择项目的评估以及在推行实践中的可能出现问题等。     

生殖健康服务中看护理工作的重要性

生殖健康概念是1994年国际人发大会后后逐步被世人所认识和接受的。我国结合本国国情将原计划生育概念转变为生殖健康概念后,给计划生育事业带来深刻变革,指导思想上不再是过去单纯以控制人口为目标,而是控制人口数量的同时强调提高人口素质,促进人口的全面发展而生殖健康服务在技术服务中起着十分重要角色,机构中的技术服务工作由从事医疗诊断、治疗、护理、药,咨询等多方面的人员来完成,     

云南省县、乡计划生育服务机构IUD放置服务的管理现状研究

目的:了解云南省县、乡计划生育服务机构IUD放置服务管理现状。方法:采用多阶段分层整群随机抽样的方法,抽取云南3个县进行横断面调查。采用情景分析法收集与IUD放置服务及其管理的相关数据及资料并进行深入分析。结果:3个县的县、乡计划生育服务机构作为农村育龄妇女最易获得服务的机构,承担了大量IUD放取工作。其管理系统运行基本正常,但3个县计划生育服务站/所IUD放置服务的管理总体尚比较粗糙,且基层计划生育服务机构间管理水平差异显著。结论:情景分析法可以对生殖健康服务及其管理提供全面、丰富和细致的信息。开展试点和研究,提高西部农村IUD放置服务的管理水平现实可行。     

计划生育手术与脏器损伤(一)

计划生育手术多是妇产科基本的小型手术,而受术者多为健康育龄妇女,涉及面广,手术量大。计划生育手术虽小,但大部分系盲视或小切口操作,手术具有一定的难度,仍会有一定的手术并发症,需要操作者具备较为扎实和娴熟的基本技术能力。现将计划生育手术可能引起的脏器损伤及其原因、诊断、处理及技术防范进行讨论,旨在引起妇产科医师、妇幼保健医师及从事计划生育技术服务人员的重视,以降低计划生育手术严重并发症———脏器损伤发生率。1计划生育手术引起脏器损伤的种类1.1放置与取出宫内节育器、负压吸宫术、钳刮术、清宫术、宫腔镜手术、腹腔…     

城市63家妇幼保健院孕期营养门诊建设状况和妊娠结局分析CSCD

目的 了解城市妇幼保健院孕期营养门诊建设状况及妊娠结局。方法 采用横断面调查方法,自行设计问卷,抽取全国28个省48个大中城市63家妇幼保健院,对其孕期营养门诊房屋设施、人员、设备等配置情况及胎儿出生体重及剖宫产率进行调查。结果 配备专职人员、同时配备产科及营养科专业人员及门诊人数≥4人的机构分别占61.90%、46.03%和49.21%,各项基本设备的配备率最高为80.95%,有49.21%和41.27%的机构同时配备基本设备和全部设备;东部地区人员专业、数目及基本设备配置符合要求的均高于中、西部地区(P <0.05);配备专职人员、同时配备两类专业人员及门诊人数≥4人、分别配备或同时配备基本设备的机构,其剖宫产率、巨大儿发生率、低出生体重儿发生率均低于配备不足的机构(均P <0.05)。结论 孕期营养门诊规范化建设对降低巨大儿、低出生体重儿、剖宫产率有促进作用,调查机构存在孕期营养门诊的基础建设、人员和基本设备配置不足等情况,亟待规范及完善,进一步促进孕期营养门诊的规范化建设。     

滨江区49周岁以上带器妇女避孕知识态度和行为调查

目目的：了解滨江区49周岁以上妇女的宫内节育器（IUD）相关知识、态度和行为（KAP）情况。方法：全区48个村社区中随机抽取12个村社区的年满49周岁及以上绝经仍带器的285名妇女进行调查。结果：调查对象对IUD相关知识得分不太高,≥60分有189人,占调查总数的66．3％;了解避孕知识最多的渠道是计生服务人员的讲解,为76．5％;对IUD满意和基本满意占89．1％,不满意的主要原因为经期长;部分妇女不知道绝经后取环的时问和原因。结论：积极开展IUD相关知识的宣传工作,要让妇女知晓最佳取环时间是绝经后0．5～1年;提高村社区计生服务人员和服务机构的技术人员的业务能力和水平;重视围绝经期妇女的生殖健康。     

On-the-job training through follow-up visits to improve the quality of family planning services

As part of a broader set of activities to strengthen family planning training and improve the quality of family planning services in Turkey, follow-up visits were performed at different family planning sites across the country in order to conduct on-the-job training. The objective of on-the-job training was to refresh and improve family planning counselling skills for all methods as well as to refresh and improve intrauterine device insertion/removal skills and also some determinants of quality care. It was also aimed at transferring up-to-date information to family planning practitioners, identifying frequently encountered problems and helping with solution approaches for problems both at the individual and programmatic levels. The results of the follow-up visits reflect issues about both the staff and the clinical facility itself in terms of conforming with the standards of the ‘National Family Planning Guidelines’ set forth by the Ministry of Health.

The follow-up team consisted of nine members who were specially trained. They represented different sectors such as a non-governmental organization, a medical school and the Ministry of Health. The follow-up team performed 90 visits to 16 clinics in 11 provinces between 1995 and 1998. Methods used were structured observations via standard checklists, meetings with the clinic staff, self-assessment, role plays, demonstration, coaching and the provision of feedback. During this period, a total of 130 health professionals working in 16 clinics were trained on-the-job. A significant improvement was observed in the performance of the family planning practitioners and the quality of care provided in clinics. While none of the service providers were found to have a standard skill level in general counselling during the first visit, at the end of the fifth visit all were capable of providing counselling services according to the national standards. Intrauterine device insertion skills were high at the beginning of the visits, and 16 of the 17 observed service providers (94%) were assessed as conforming to the standards, At the fifth visit, all of the 42 service providers (100%) were found to be adequate. At the facility level, all 16 clinics established separate counselling rooms in the follow-up period. Additionally, the number of clinics conforming to infection prevention standards increased from two clinics in 15 at the first visit to all 16 clinics at the fifth visit. This study showed that the ultimate success of family planning programs depend on structured and well-supervised on-the-job training through follow-up visits to the sites.     

On-the-job training through follow-up visits to improve the quality of family planning services.

As part of a broader set of activities to strengthen family planning training and improve the quality of family planning services in Turkey, follow-up visits were performed at different family planning sites across the country in order to conduct on-the-job training. The objective of on-the-job training was to refresh and improve family planning counselling skills for all methods as well as to refresh and improve intrauterine device insertion/removal skills and also some determinants of quality care. It was also aimed at transferring up-to-date information to family planning practitioners, identifying frequently encountered problems and helping with solution approaches for problems both at the individual and programmatic levels. The results of the follow-up visits reflect issues about both the staff and the clinical facility itself in terms of conforming with the standards of the 'National Family Planning Guidelines' set forth by the Ministry of Health. The follow-up team consisted of nine members who were specially trained. They represented different sectors such as a non-governmental organization, a medical school and the Ministry of Health. The follow-up team performed 90 visits to 16 clinics in 11 provinces between 1995 and 1998. Methods used were structured observations via standard checklists, meetings with the clinic staff, self-assessment, role plays, demonstration, coaching and the provision of feedback. During this period, a total of 130 health professionals working in 16 clinics were trained on-the-job. A significant improvement was observed in the performance of the family planning practitioners and the quality of care provided in clinics. While none of the service providers were found to have a standard skill level in general counselling during the first visit, at the end of the fifth visit all were capable of providing counselling services according to the national standards. Intrauterine device insertion skills were high at the beginning of the visits, and 16 of the 17 observed service providers (94%) were assessed as conforming to the standards. At the fifth visit, all of the 42 service providers (100%) were found to be adequate. At the facility level, all 16 clinics established separate counselling rooms in the follow-up period. Additionally, the number of clinics conforming to infection prevention standards increased from two clinics in 15 at the first visit to all 16 clinics at the fifth visit. This study showed that the ultimate success of family planning programs depend on structured and well-supervised on-the-job training through follow-up visits to the sites.     

"Financing Family Planning Services: Is Categorical Legislation Still Needed?" Drs. McFarlane and Meier Respond

Authors of the article "Financing Family Planning Services: Is Categorical Legislation Still Needed?" in the September-December 1991 issue of the American Journal of Gynecological Health, respond to a charge by the Executive Director of the Los Angeles Regional Family Planning Council that data presented on California's 1987 expenditures for family planning services were erroneous. Data presented in the article were obtained and reprinted from a 1988 article in Family Planning Perspectives by Rachel Benson Gold and Sandra Guardado. The figure of $27,000 was for contraceptive services exclusive of expenditures for sterilization, infertility, or extraclinical education. This figure was later adjusted in Volume 21 of Family Planning Perspectives to $27 million. Accordingly, total state funds spent nationwide was $76 million and national expenditures were $412 million. The authors were unaware of these corrections when their article went to press and thank their critic for bringing attention to the error. Even so, the author's original conclusion holds that categorical legislation is needed for family planning.     

Family Planning Technician

Family Planning Technicians were added to the hospital staff to supplement multimedia family planning education in an impatient setting. Staff believed that family planning information could be offered the patient on the ward as a routine hospital service, ordered by the physician, and provided at a convenient time during the hospital stay. Women with whom the patients could easily identify were chosen and trained for their new roles. The service was designed to meet the needs of patients and hospital staff. The new service has become an integral part of the hospital. This report summarizes the first year's experience.     

眉山市不同机构流产服务的现状及其评价

目的:了解和评价眉山市不同服务系统和等级医疗机构流产服务质量。方法:采用服务机构现场观察、技术人员深入访谈和流产妇女半结构式访谈等研究方法。结果:结果表明,该市流产服务可获得性良好,但服务对象对多数机构的服务环境和硬件设施以及技术人员优质服务意识和态度或多或少存在不满。观察发现多数服务的基础设施与群众对流产优质服务的要求存在不少差距,国家计划生育技术常规没能够严格执行,特别是预防术后感染、药物流产方案的执行、流产后避孕服务等重视不够。结论:要加强流产服务基础设施建设,提高技术人员优质服务意识,特别要加强流产服务整个过程中生殖道感染预防、流产后计划生育服务及严格执行药物流产技术常规。     

Changes in midwifery practice. 26. Postwar legislative guideline concerning family planning

Yoshio Furuya, who authored the 1951 legislative guidelines for family planning in Japan, designated 3 villages to model family planning upon his return from the United States in 1950. The instructors were public health nurses, midwives and regular nurses who had been trained and certified by the National Public Health Institute. They showed film strips and slides, and distributed contraceptives and medication. Population Research Group also embarked on the New Life Style Movement among Japanese industries in 1951. The new life style was said to have 3 pillars: family planning, career planning, and family morals. The idea of family planning was welcomed at the beginning by industries because it would mean less dependents of employees to provide financial aid for. The movement lasted only several years. In 1955, the International Family Planning Federation and the Japan Family Planning Federation co-sponsored the Fifth International Family Planning Conference in Tokyo. 572 participants including Margaret Sanger delivered 91 papers on techniques and practices of family planning. Soon after the conference, the Family Planning Study Committee was organized, and they met once a month to discuss socio-cultural implications of family planning, theory and practice of contraception, maternal and child health. Many of the committee members were idealistic/feminist public health officials but there were no women among them. A post-war family planning movement approved by the Japanese government resulted in the dramatic reduction in the birth rate from 34.3% in 1947 to 17.2% in 1957. Midwives played an important role in enforcing the policy but they were excluded from policy making.     

The role of the federal government

A review of the role of the federal government in abortion administration in view of prospective legalization of abortion. It is argued that abortion is a woman's right and should be considered purely a medical decision, but it is acknowledged that for political expediency, the majority of Congress is theoretically opposed to abortion. It is expected that this will change in the next 5 years. In the meantime the federal courts have taken the lead in repealing present abortion laws. In light of this, legislation has been introduced in Congress to guarantee safety standards in abortion procedures and equalize abortion laws across the country. The Family Planning Act is providing money to family planning clinics and Section 314 of the Public Health Services Act provides money to state health services where the state sees the need. These are 2 measures that can indirectly provide financial support for abortion. An addendum includes a review of New York State's experience with abortion in its first year of its liberalized abortion law, showing handling of a mass abortion program with increasing safety and efficiency.     

Graduate family planning training. An evaluation

The National Center for Family Planning Services in response to the need to improve and expand physician training in family planning in 1972 encouraged the development of model training programs in clinical family planning. An intensive training program in family planning was presented to small groups of physicians during a 6 month period. The goal was to provide new professional skill which would be used in delivering birth control services throughout the country. The entire training course won consistent approval from the repondents. The sexuality core course was by far the most popular among the respondents. Of the 34 respondents, 29 liked the program enough to highly recommend it to others and 4 said that they would recommend it.     

Hospital-based family planning program

To improve the family planning program at Temple University Hospital, the charts of 1526 service patients were analyzed in 1966. Total ward deliveries showed 855(56%) were married, while 671(44%) were single, separated, divorced or widowed. 834(55%) accepted some method of birth control. 44% of the 1526 returned for postpartum visits. It was revealed that a large number of welfare recipients accepted family planning than did those whose hospital bill was paid. Family planning services should be made an integral part of already established obstetric and gynecologic programs. The addition of indigenous personnel from the community serving the team of physicians, nurses, and social-workers will expedite the accepting of family planning information and services.