西部农村地区村卫生室不同发展模式的比较与研究

  目的   了解川藏少数民族地区村卫生室妇幼服务情况，为制定进一步的干预方案提供参考依据。  方法   采用按容量比例概率抽样法，于2016年9 — 11月，对西藏2县30个行政村、四川凉山彝族自治州2县30个行政村卫生室的人员、用于妇幼服务的设备及物品、基本妇幼服务内容等进行调查。  结果  被调查地区妇幼专干23人，平均每村0.38人；村卫生室妇幼服务设备及物品情况：55所（91.67 %）无儿童心理行为发育评估表和精准秒钟，50所（83.33 %）无口服补液盐，46所（76.67 %）无卧式量床，36所（60.00 %）无肺炎抗生素，35所（58.33 %）无母子保健卡，33所（55.00 %）无儿童体重秤；村卫生室服务情况：53所（88.33 %）未开展接生，46所（76.67 %）未开展心理发育咨询，45所（75.00 %）未开展儿童心理行为发育筛查，41所（68.33 %）未开展早期发展指导，39所（65.00 %）未开展耳及听力保健。  结论  川藏少数民族地区村卫生室缺乏专职妇幼保健人员，能用于妇幼保健的设备物品总体严重不足，能开展的妇幼保健服务严重不够，基层妇幼保健工作亟待加强。

Baseline capability of village clinics for maternal and child health care services in minority areas of Sichuan province and Tibet

  Objective   To examine the status of maternal and child health care service provided by village clinics in minority areas of Sichuan province (Sichuan) and Tibet Autonomous Region (Tibet) and to provide references for making effective intervention plan.   Methods   Using probability proportional to size (PPS) sampling, we conducted surveys on personnel, medical facilities and equipments, and service items of maternal and child health care in 30 villages of 2 counties in Tibet and 30 villages of 2 counties of Liangshan Yi Autonomous Prefecture of Sichuan between September and November 2016.   Results   There were totally 23 staff specially assigned for maternal and child health care service in the 60 villages surveyed, averagely 0.38 staff for each village. Of the village clinics surveyed, 55 (91.67%) were not equipped with psychological behavioral assessment instruments for children and precise stopwatch; 50 (83.33%) did not reserve oral rehydration salts; 46 (76.67%) were not equipped with horizontal measuring bed; 36 (60.00%) did not reserve antibiotics for pneumonia treatment; 35 (58.33%) did not establish record cards for maternal and child health care; 33 (55.00%) were not equipped with weighting scale for small child; 53 (88.33%) did not carry out delivery service; 46 (76.67%) could not conduct psychological development counseling; 45 (75.00%) could not perform psychological behavioral development screening for children; 41 (68.33%) did not provide early development instruction; and 39 (65.00%) did not implement hearing health care for small children.   Conclusion   The village clinics in minority areas of Sichuan and Tibet were of inadequate capability for maternal and child health care services because of lacking full-time staff and necessary facilities and equipments; the situation needs to be improved urgently.