黄浦区社区儿童、妇女(生殖)健康的社区诊断与分析

Community Asseseement and Analysis about Health Situation of Children and Women in Huangpu District,Shanghai

目的了解社区儿童、妇女(生殖)健康的主要问题和影响因素,为开展健康促进干预明确优先项目,把有限资源应用于妇女、儿童健康最关切、干预最有效的项目上。方法收集、利用现有的相关统计信息资料,用专题小组讨论、访谈等定性研究方法收集社会、教育、管理与政策资料;用系统随机方式抽6个社区450名妇女,作儿童、妇女(生殖)健康的"知识、信念(态度)、行为"方面的调查。结果该区域人口结构"老化",女性人口中45岁～55岁年龄组最多,占24.11%,区域的社会环境呈现"二元化"的特征;肥胖儿童检出率为6.06%,有视力异常可疑19.22%;各类妇科疾病的患病率为32.86%,以子宫肌瘤、宫颈疾病、卵巢肿块、生殖道感染为主;乳腺癌死亡率为19.69/10万,发病率为62.87/10万;生殖健康的知识、态度、行为正确率分别为77.15%、61.73%、36.73%(P<0.01);婚前医学检查率8.96%;围产儿出生缺陷发生率为11.03‰;妇幼保健人员45岁以上医护人员占54.88%,大专以下学历人员占58.82%;区域内各部门之间有联系但不紧密。结论社会环境呈现"二元化"特征,感染性疾病与生活方式病并存,健康行为缺失,健康信念需强化,建立多部门的合作是开展健康促进的关键。

Objective To understand main problems and effective factors on community children and women in order to determine priorities in health promotion intervention. Methods Reviewing valuable statistical information and apply group discussion, interview and other qualitative research methods to collect social, education, management and policy data; and research knowledge, attitude, practice on 450 women. Results The population structure of this area showing ageing, the female number aged 45 to 55 are the most, accounting for 24.11%, the social environment of the region showed binary; the Screening data of obese children and abnormal vision was respectively 6.06% and 19.22%; the prevalence rate of all kinds of gynecological diseases is 32.86%, and made up of hysteromyoma, disease of cervix, ovarian tumors and genital tract infection; the mortality and morbidity of breast cancer was respectively 19.69/10 000 and 62.87/100 000; the correct rate of knowledge, attitudes, behaviour about reproductive health was respectively 77.15%, 61.73%, 36.73%; the pre-marital medical examination rate is 8.96%; the perinatal birth defect rate was 11.03 ‰; over the age of 45 maternal and child health care workers accounted for 54.88% and below the tertiary qualifications accounted for 58.82%;there were link in sectors in this area but this link is not closely. Conclusion The establishment of multi-sectoral cooperation is the key to health promotion.