卫生Ⅷ项目对孕产期保健服务利用公平性的影响

目的探讨卫生Ⅷ项目在实现孕产期保健服务利用公平性目标中的作用。方法利用"卫生Ⅷ项目/卫生Ⅷ支持性项目对母婴保健与健康影响"专项评估中的孕产妇入户调查数据库,分析项目县和非项目县不同家庭收入妇女利用孕产期保健服务的差异。结果综合试点县和一般项目县的各项产前、产时和产后保健服务利用率的"最高收入组-最低收入组"的极差都不同程度地低于对照县,且随收入变化的等级趋势也明显弱化。结论乡镇卫生院建设和住院分娩费用减免等项目措施的综合实施,有效地提高了贫困孕产妇利用基本孕产期保健服务的可及性和可负担性,从而改善了孕产妇医疗保健服务利用的公平性。

Impact of Health Ⅷ Project on Equity of Maternal Care Utilization

OBJECTIVES To explore the impact of China Basic Health Project (H8P/SP) on equity of maternal care utilization. METHODS The household survey data in final evaluation study of H8P/SP on maternal care and maternal and child health were used in the present analysis. RESULTS By calculating various rates of prenatal care utilization,hospital delivery,and postnatal care utilization according to quintiles of per capital household income,it could be found that the rate differences between highest-income group and lowest-income group were smaller in both DFID counties and general H8P/SP counties but larger in control counties. The maternal care utilization rates increased as the income increased in control counties,but such kind of positive association with drew in H8P/SP counties. CONCLUSIONS H8P/SP is effective in reducing inequity of maternal care utilization in poor rural China. Availability and affordability of basic maternal care services have been greatly improved through comprehensive intervention strategies of strengthening township hospital and providing health care reimbursement.