贫困农村实施“关注儿童早期发育”项目的可行性研究

Feasibility of the programme of Focusing on early childhood development in impoverished rural areas in China

目的探讨贫困农村实施“关注儿童早期发育”项目的可行性,为该项目的进一步推广提供可靠的依据。方法选择年均收入800元人民币左右的安徽省国家级贫困县(长丰县)下属7个行政村2岁以下正常健康儿童100名以及他们的母亲,以电脑产生随机数字的方法分为试验组(给予项目干预)和对照组。通过问卷的方式了解项目实施前后母亲对儿童发育知识了解的状况及对该项目态度的变化,了解29名村医在实施项目前后认识和工作质量的差异,通过Gesell测试观察项目实施对儿童发育水平的影响。结果项目实施后试验组母亲对该项目十分认可并能积极地把项目所授内容付诸实践。村医的工作内涵有了较大的扩展但对该项目的态度没有明显改变。项目实施半年后,两组儿童在精细运动、言语和人际交流等方面差异有统计学意义(P均<0.05)。结论“关注儿童早期发育”项目是适于在中国贫困农村开展的一项经济、简便、有效的技术。

Objective To study the feasibility of the programme “Focusing on early childhood development” in impoverished rural areas in China.Methods A questionnaire survey was conducted among 100 mothers, about half with junior middle school education, 18% with grade-school education, and 29% being illiterate, of children aged under two years in 7 villages in Changfeng County, Anhui Province, a native impoverished county, to understand their knowledge and attitudes about child healthcare. Then these mothers were randomly divided into 2 equal groups: experimental group, receiving face-to-face guidance in the practice of early healthcare for children at home with a pamphlet developed by WHO as teaching material; and control group without receiving guidance. Two months later the mothers received the second session of guidance. Six months after the same questionnaire survey was conducted among the 100 mothers to investigate the changes in knowledge and practice and Gesell development test was made to observe the changes in mental development. Two-days' training on the technique of early child healthcare in the form of reading, videotape presenting, and exercise, was given to 29 village doctors. Questionnaire survey was conducted among them before and 1 month after the training to understand the changes of their knowledge and attitudes towards early child healthcare.Results After the guidance the knowledge and fostering skills in terms of early child healthcare were improved significantly among the mothers of the experimental group in comparison with the mothers of the control group (P<0.01). After the training most of the village doctors managed put the knowledge they had learned into practice, however, the percentage of those who lacked confidence in the smooth implementation of the programme remained unchanged (38% vs. 41%). Before the experiment the abilities in different fields were not significantly different between the children in these 2 groups. Six months after the implementation of the programme the abilities in fine motion, speech, and interpersonal communication were improved significantly among the children of the experimental group (all P<0.05). Conclusion Economic, simple, and effective, the programme “Focusing on early childhood development” is suitable for the impoverished rural areas in China.