中国乡级计划生育服务站技术服务提供及服务能力跨地区分析

A cross-regional comparative analysis on the provision of technical service and service capacities of township family planning service stations in the three economic regions of China

目的根据2001年全国计划生育和生殖健康调查资料,对我国东、中、西部三大经济地区乡级计划生育服务站的技术服务提供及服务能力进行跨地区比较分析。方法全国抽样调查,采用分层、三阶段、概率比例抽样方法。对776个计划生育服务站和负责人采用观察与询问的方式进行问卷调查。结果全国农村样本点乡站放置和取出宫内节育器年均258.5例次,开展女性绝育术年均38.5例次,实施人工流产术年均29.6例次,三地区间差异有统计学意义(P<0.05)。开展男性绝育术和皮下埋植术年均分别为10.4例次和2.5例次,三地区间差异无统计学意义(P>0.05);在样本点中,95%(737/776)的乡站有B超设备,其中B超服务用于宫内节育器检查和妇科疾病诊断的乡站比例分别为69.5%(509/737)和55.0%(405/737);提供常见妇科疾病诊治、产前检查、不育症诊治的比例分别为84.1%、76.8%和25.4%,提供性病诊治比例为19.5%;提供妊娠试验、血尿便常规检查和宫颈涂片的比例分别为91.4%、18.6%和9.8%。精液检查比例为3.5%;提供短效、长效和速效口服避孕药的比例分别为95.6%、89.7%和71.3%。提供紧急避孕药的比例为24.7%。提供避孕套的比例为97.8%;能提供咨询服务的乡站比例75.6%,设有“悄悄话”室乡站的比例为52.1%;提供术后和产后随访服务的比例分别为85.4%和38.3%。结论全国农村样本点乡站在提供计划生育手术服务、发放避孕药具,以及围绕着生育、节育和不育开展力所能及的生殖保健服务方面已经具备相当能力,但各地的技术服务提供和服务能力发展并不均衡,东、中、西部地区的差别明显。表明我国基层计划生育服务站改革已是一种必然趋势,改革的方向应遵照国家人口计生委关于服务站建设的总体发展格局对乡站进行优化和整合。只有改革才能加快乡站服务能力建设,才能提高服务水平,才能适应客观需求,才能让广大农村育龄群众得到满意的服务。

Objective Using data from the National Family Planning/Reproductive Health Survey, to conduct a comparative analysis on the provisions of technical services and service capacities of township family planning service stations in the three economic regions （east, middle and west） of China,. Methods The national samples were selected through stratified, threestage, and PPS methods. Information was collected from the family planning service stations of sampled township through observations and interviews using questionnaires designed for township stations. Results IUDs insertion/removal, female sterilization and induced abortion provided by the township stations were 258.5, 38. 5 and 29. 6 person-times per year on average. The differences in the provision of those services among three regions were highly significant. The annual provisions of male sterilization and subdermal implants were 10. 4 and 2.5 person-times on average. And there were no significant differences among three regions. 69.5 % and 55.0 % of the sample stations applied B type ultrasonic machines to examine IUDs and diagnose gynecological diseases. 84. 1%, 76.8 %, 25.4 %and 19.5 % of the sample stations provided diagnosis and treatment of common gynecological diseases, prenatal checkup, diagnosis and treatment of sterility, and diagnosis and treatment of STDs, respectively. And 91.4 %, 18. 6 % and 9.8 % of the stations could provide pregnancy test, routine blood, urine and excrement, and cervical smear examination. Only 3.5 % of the stations could provide examination of semen. 95.6 %, 89.7 % and 71.3 % of the stations could provide short-effect oral pills, long-acting oral pills and quick-acting oral pills respectively. Only 24.7 % of them could provide emergency contraceptives. 97, 8 % of the stations could provide condoms. 75.6 % of them could provide counseling services. 52.1 % of the stations had ＂whisperings＂ rooms. 85.4 % and 38.3 % of them could provide follow-up visits after family planning operations and post-natal follow-up visits. Conclusion The sampled township stations have had some capacities to provide family planning operations, to delivery contraceptives, and to carry out some reproductive health care services on childbirth, birth control and infertility. However, the service capacities and services provisions were imbalance in three regions. The difference between the East, the Middle and the West of China were significant. The gap between the West and the other two regions were especially obvious. Therefore, it is necessary to reform the family planning service stations at the grass-roots level. The reformation should be focused on integrating and optimizing the tow.nship stations under the whole frameworks for the development of family planning stations set up by the State Population and Family Planning Commission of China. In order to improve the services, to meet the objective needs, to ensure the rural population of the child-bearing period obtaining satisfactory services, there is no way but carrying out reformation to improve the capacity establishment of the township family planning stations.