中国部分地区妇女产前保健利用的公平性及其相对变化

目的评价部分地区妇女在产前保健利用方面的公平性状况和相对变化。方法数据来自北京大学生育健康研究所在13个县（市）的围产保健监测系统,研究对象为1994年和2000年分娩了单胎活产儿的103704名妇女。应用x^2检验、多元logisitc回归和计算集中指数方法,比较不同文化程度妇女的系统管理率、相对危险度和集中指数。结果1994年的系统管理率为22．1％,2000年为57．4％。总的集中指数由1994年的-0．046上升为2000年的0．066。北方地区的集中指数由1994年的0．015上升为2000年的0．295,南方地区的集中指数由1994年的-0．015上升为2000年的0．062;农村的集中指数由1994年的0．002上升为2000年的0．026,城市的集中指数由1994年的0．042下降为2000年的0．019。结论不同文化程度的妇女在产前保健利用方面存在不公平性,近年来除城市稍有缓解外,多有所加剧,北方地区尤其严重,需要引起重视。

The extent and relative changes of equities in utilization of prenatal care among women in some areas of China

Objective To assess the extent and relative changes of the equities in prenatal care utilization among women with different educational attainment in some areas of China. Methods Data were collected in 13 counties/cities covered by Perinatal Health Care Surveillance System established by Institute of Reproductive and Child Health, Peking University. The study population consisted of 103 704 women who delivered single live births in 1994 and 2000. Chi-square and multiple logistic regression were employed to compare the systematic management rates and relative risks. Concentration index was used to assess the relative changes of equities in prenatal care utilization. SPSS 11.5 and Microsoft Excel 2003 were used for analysis. Results The total systematic management rate was 22. 1% in 1994 and 57. 4% in 2000. The concentration index was - 0. 046 in 1994 and 0. 066 in 2000. In northern areas, the concentration index increased from 0. 015 in 1994 to 0. 295 in 2000, while it increased from - 0. 015 in 1994 to 0. 062 in 2000 in southern areas. In rural areas, the concentration index increased from 0. 002 in 1994 to 0. 026 in 2000, while it decreased from 0. 042 in 1994 to O. 019 in 2000 in urban areas. Conclusion Inequities in prenatal care utilization in 2000 heeome more obvious than in 1994, especially in northern areas. More attention should be paid to solve the inequities.