云南省人口计生部门出生缺陷一级干预服务的提供和利用研究

Research on the Provision and Utilization of the First Level Intervention of Birth Defects in Yunnan Province

目的:通过对出生缺陷一级干预服务的提供和利用状况进行分析,从服务提供的角度,提出改进服务细节的建议。方法:采用定量、定性研究方法,对云南省红河州7个试点县为期3年的降低新生儿出生缺陷率的综合防治技术研究的项目实践,了解目前县、乡两级计划生育服务机构的服务能力和服务水平,育龄夫妇对这些服务的了解程度、利用情况及主要影响因素,收集现场的有关数据。结果:7个县计划生育服务机构具备了开展出生缺陷一级干预的相关工作基础和条件,3年中有超过40%的目标人群接受了所提供的各类服务,其中健康教育率为73.14%,叶酸增补率为41.63%。以全面实施三级干预的1个县为例,2005年6月～2006年12月共计出生婴儿5151人,参加队列研究的4058人,占出生人数的78.78%,项目筛查出了部分有生育出生缺陷儿风险的目标人群,通过积极干预避免不良妊娠结局的发生。结论:通过服务提供者的能力建设,健全技术服务标准和规范,加强咨询,提供优质规范的服务,促进育龄群众对服务的利用。

Objective： To analyze the situation of the provision and utilization of the first level intervention of birth defects, and propose suggestions to improve service details from the service provision aspect. Methods： The quantitative and qualitative investigation were adopted to fulfill the integrate control project to cut down the ratio of birth defects in the 7 selected counties in Honghe State for 3 years. Through this project, the current situation of the service ability and quality of the family planning units were examined in counties and countryside. Also, the related data were collected, including the comprehensive extent, the utilization and the major influential factors of these services among reproductive aged couples. Results： The family plan- ning units in these 7 counties had the basic faculties and conditions to carry out the related work for the first level intervention of birth defects. More than 40% target population received all various kinds of services in the 3 years. Among them, 73.14% received health education, and 41.63% received folic acid supplement. Taking an example of one county where comprehensive interventions were implemented, the total births were 5,151 from June 2005 to December 2006, and 4,058 newborns （78.78%） were investigated using cohort study. The target population with the risk of breeding infants with birth defects was identified through this project, and the dys - pregnancy outcome was avoided by adopting positive intervention measures. Conclusion： The high -test and normal service provision can be achieved by improving the service providers＇ability, perfecting the service criteria, and strengthening consultation. And then the service utilization of reproductive aged couples will be promoted.