以工作场所为基础的干预对流动人口性与生殖健康咨询服务的影响

The impacts of workplace-based intervention on migrants' sexual and reproductive health counseling service

目的评估以工作场所为基础的干预对流动人口性与生殖健康咨询服务的影响。方法多阶段整群抽取上海市闵行区流动人口集中的工厂、建筑工地、服务娱乐场所,随机分为干预组和对照组。通过倡导、动员,管理,培训,计划生育宣传教育服务,性与生殖健康咨询服务,避孕节育技术服务,随访服务,转诊机制等干预活动对研究对象进行避孕节育、生殖健康综合服务干预。应用χ2及有序多分类Logistic回归分析等方法对其影响进行分析。结果本研究基线共调查2001人,评估调查时随访到有效样本1791人(失访率10.49%)。基线调查时,对照组和干预组对象接受过咨询服务的比例分别为16.65%、17.82%,两组比较差异无统计学意义(P>0.05);评估调查时,干预组对象接受过咨询服务的比例为36.77%,高于对照组的17.69%,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示干预促进了流动人口接受性与生殖健康咨询服务,近似值差异率(oddratio,OR)为2.802,95%可信区间为(2.190,3.584)。基线调查时对照组和干预组有咨询服务需求的比例分别为63.87%、66.93%;评估调查时分别为65.27%、67.14%,两组相比较差异均无统计学意义(P>0.05),多因素分析也显示干预对研究对象的咨询服务需求没有显著性影响。结论干预项目取得一定成效,促进了流动人口接受性与生殖健康咨询服务的比例,但仍未满足需求。今后需要加强对流动人口性与生殖健康相关的咨询服务。

Objective To evaluate the effects of workplace -based intervention on sexual and reproductive health counseling among migrants in Minhang District, Shanghai City. Methods Interventions were as follows： advocacy, mobilization, management, training, IEC, sexual and reproductive health counseling services, contraception technical services, follow - up services and referral mechanisms. The subjects were divided into intervention group and control group, multi - stage random cluster sample of Minhang District, Shanghai City, those worked in factories, construction sites, services places of entertainment respectively. Results Total 2 001 migrants were surveyed in the baseline and 1 791 was followed in the evaluation survey. The proportions of receiving counseling service were 16. 65% and 17.82% in control and intervention group respectively at the baseline survey that the difference was no significant （ P 〉 0. 05 ）. After intervention, the proportion of intervention group increased to 36. 77% which was higher than that of control group（ 17.69% ） that the difference was significant（ P 〈 0. 05 ）. Multilogistic analysis showed that the intervention promoted migrants to receive counseling service and the odd ratio（OR） value was 2. 802 [95% confidence interval（CI） ： 2. 190,3. 5841. The proportions of counseling demands in control and intervention group were 63.87% and 66. 93% in baseline survey, which were 65.27% and 67.14% in evaluation survey. Those had no statistically difference （ P 〉 0.05 ） and multi - logistic analysis didn＇ t find the significant influence on counseling demands. Conclusion The intervention program had some influences on the improvements of getting sexual and reproductive health counseling, but it was far from the meet of demands of migrants. So more counseling services should be provided to migrants in the future.