米非司酮药物流产使用情况的调查研究

本研究以定量和定性方法对我国三省市药物流产的使用情况进行调查,目的在于了解使用者和服务提供者关于药物流产信息和知识的来源和质量;不同级别医疗单位提供药物流产服务的情况及政府管理部门对药物流产的管理情况。调查在北京、广东和湖南三省市进行。结果发现,部分提供者对药物流产的禁忌证了解不够或执行不当;各地对流产前的检查项目掌握不一致,一些不必要的检查增加了使用者的经济负担;部分使用者未能按常规要求在医院服用半非司酮和米前列醇;有些提供药物流产服务的单位未按政府要求进行登记;不少提供者在治疗药物流产后出血时使用价格昂贵的药品;不同地区或单位药物流产的价格差别很大;尽管在咨询和流产后避孕指导方面,尚需改进,多数使用者对药物流的的服务表示满意。本文对加强药物流产的管理提出建议。

An Investigation of Mifepristone Use for Medical Abortion in Beijng, Hunan and Guangdong.

noted areas for improvement in counselling and provision of postabortion family planning services.An investigation of mifepristone use for medical abortion in three provinces in China used both quantitative and qualitative research techniques. The objectives of this study are to find out the source and quality of client and provider information about medical abortion, to determine the guidelines for medical abortion, to determine how medical abortion is managed in clinic settings and to access the client and provider perspectives of quality of care at different levels of the family planning clinic system. This study was conducted in Beijing, Hunan and Guangdong. Among the key findings of the investigation were that recommended contraindications to mifepristone use were not always known or followed by providers; use of recommended pre-treatment examination procedures varied widely and, in some cases, unnecessary tests added to the cost of treatment; a portion of women were given mifepristone and/ or the prostaglandin to take at home, rather than at the clinic as specified in national service delivery guidelines; clinics providing mifepristone services often were not government certified, as required; many providers recommended use of a range of auxiliary drugs to control bleeding; costs of mifepristone services varied widely, and most clients were satisfied with services received, though