控制剖宫产率政策措施的效果研究——以江苏省4县为例

目的:总结江苏省4县为控制剖宫产率采取的政策与经济措施,并分析其成效,为控制剖宫产率提供可推广的经验方法。方法:对2009—2013年江苏省4县的住院自然分娩人数和剖宫产病例进行分析,比较剖宫产率的变化情况、孕产妇和新生儿死亡情况、剖宫产指征变化情况。结果:5年间4县平均剖宫产率呈逐年下降趋势,从2009年的60.2%下降至2013年的48.1%。结论:干预措施有效,但发挥作用有限,应加强社会各方对干预措施的重视程度,建立监督考评机制,规范接产医院医疗行为,加强助产技术培训,在政府部门配合下进行干预措施的推广。

The effects of the policy measures to control the rate of cesarean section in four counties

Objective:To explore the propagable experience and methods of controlling the rate of cesarean section through the summary of the innovative measures in four counties. Methods: The cases of natural birth and cesarean section from 2009 to 2013 in four counties were analyzed respectively. The interventions of controlling cesarean section rate have been summarized. Results: The average cesarean section rate of four counties in five years is on the decline, since 2009 the rate were 60.2%,62.3%,59.3%,51.4%,48.1%. Conclusions: The interventions really worked, but did not do the best. Improving the social attention on these innovative measures, strengthening surveillance mechanism, regulating the medical behaviors of delivery hospitals, enhancing the midwifery training and promoting the interventions under the coordination of local government can further reduce the rate of cesarean section.