中国农村计划生育技术服务质量状况及评价

根据1997年全国人口与生殖健康调查提供的资料对中国农村计划生育技术服务质量的现状进行分析和评价。该调查的第二阶段调查共随机抽取农村已婚育龄妇女9714人,其中曾做过节育手术者669人。由卫生系统各级医疗机构实施的手术占65.7％,由各级计划生育服务机构实施的手术占34.3％。按照手术类型分为女性绝育、放置宫内节育器、人工流产和其他四类手术,妇女最后一次手术时医疗技术服务人员向她们介绍过这种手术的比例依次分别为34.7％、42.3％、33.3％和36.3％。术后给予避孕和保健指导的比例依次分别为40.9％、60.7％、52.4％和45.0％。术后随访的比例依次分别为25.0％、23.0％、9.6％和14.0％。这一结果表明,我国农村计划生育手术服务方面有了相当大的改善。在70年代初术前介绍、术后指导和随访的比例分别为30.1％、44.6％和19.3％。而90年代末则分别增至46.0％、62.7％和22.7％。术后随访仍是一个薄弱的环节。接受过手术的妇女对上述四类手术的满意比例依次为76.5％、80.4％、73.5％和74.7％。调查结果显示,术前做过介绍、术后提供指导和随访的受术妇女,其对手术满意的比例均高,不满意的比例均低。反之亦然。在讨论中指出,在我国广大农村地区已婚育龄妇女在生殖健康方面的自我保健意识和需求仍停留在较?

The Quality of Family Planning Technical Service and Evaluation in Rural China.

Family planning (FP) technical service is of great significance to the implementation of the FP program and health of people of childbearing age. The reproductive health part of the NDRHS in 1997 randomly surveyed 9 714 married women of childbearing age in rural areas,of whom 8,669 had birth control operations. Of these women,65. 7% had the operation in medical institution at all levels and 34- 3% in FP service centers at all levels. 34. 7%,42. 3%,33. 3% and 36. 3% received pre operation introducation when having the last female sterilization,IUD insertion,induced abortion and other operations respectively. The proportion is 40. 9% ,60. 7% ,52. 4% and 45. 0% respectively for receiving instructions on contraception and health care after the four types of operations ,and it is 25. 0%, 23. 0% ,9. 6% and 14. 0% respectively for receiving post -operation home visits. These indicate that there is still a gap between services received by rural women and requirements of quality service. China has made great achievements is improving FP technical services since ICPD in 1994. In the early 1970s, the proportion of preoperation introducation, post operation instrucation and follow-up visit was 30. 1%,44. 6% and 19.3% respectivesy,however,it increased to 46. 0%,62. 7% and 22.7% respectively in the late 1990s. Follow-up visit remains a weakness. Among women who have had these operaions,76. 5% ,80. 4% ,73. 5% and 74. 7% are satisified with the four types of operations respectivesy. The survey results show that the proportion of "satisfied"is high among women who have received pre operation introduction,post operation instruction and follow-up visit,and vice versa. It was pointed out that health awareness and demands for reproductive health remain a low level among married women of childbearing age in rural China. Therefore,in order to promote quality service,publicity should be enhanced to heighten women's awareness of health. Meanwhile, grassroots service providers shousd be trained to meet the ever-increasing needs for reproductive health. The pilot work of the quality of care program launched by the State Family Planning Commission has gained valuable experiences that can be followed by other localities. The FP department and public health sector should work together to implement the quality of care program and further promote the FP/RH program.