四川省实施卫生部/全球疫苗免疫联盟提高边远少数民族地区新生儿乙型肝炎疫苗首剂及时接种率项目评价

Analysis of the Project Effect on MOH/GAVI Increasing the Coverage Rate of Timely-birth Dose Hepatitis B Vaccine in the Remote Minority Areas in Sichuan Province

目的探索提高边远少数民族地区新生儿乙型肝炎(乙肝)疫苗(Hepatitis B Vaccine,HepB)首剂(First Dose)(HepB1)及时接种率的有效策略。方法选择HepB1接种率较低的阿坝藏族羌族自治州和凉山彝族自治州,进行HepB1及时接种、未接种或未及时接种的原因等问卷调查,分析影响HepB1及时接种的因素,并开展健康教育、专业培训和督导,加强与妇幼保健机构及医院合作等干预措施,评价干预措施效果。结果采取干预措施后,HepB1及时接种率由干预前的49.19%提高到67.83%,儿童家长/监护人乙肝防治知识知晓率由15.41%提高到31.57%,乡村级医务人员乙肝防治知识知晓率由47.39%提高到82.54%,差异均有统计学意义。结论积极开展社会宣传动员和基层医务人员乙肝知识培训,加强与妇幼保健机构及医院合作,能够提高边远少数民族地区HepB1及时接种率。今后还需加大对孕产妇住院分娩优惠政策的宣传力度,逐步提高住院分娩率,同时邀请宗教领袖向公众宣传HepB1及时接种的知识。

Objective To explore the effective measures to increase the timely-birth dose of hepatitis B vaccine in the remote minority areas. Methods To find out the influencing factors, we conducted the questionnaire surveys in Aba Zang and Qiang autonomous prefecture and Liangshan Yi autonomous prefecture where are the low coverage rate of timely-birth dose hepatitis B vaccine about the birth dose of hepatitis B vaccine on time or not and the reasons. To evaluate the interventions effect after interventions carried out. Intervention strategies such as the health education, professional training cooperation with the maternity and child care institution and hospital. Result Affer the interventions, the coverage rate of timely-birth dose hepatitiis B vaccine increased from 49.19% to 67.83%; the hepatitis B prevention and control knowledge knowing rate of the parents increased from 15.41~ to 31.57%; the hepatitis B prevention and control knowledge knowing rate of the doctors raised from 47.39% to 82.54%. The differences have statistics significance. Conclusion It is very important to increase the timely HepB1 of children in remote and minority areas through active publicity activities and training for the EPI doctors at grass-root level, and strengthen the cooperation with MCH and hospitals. To increase the rate of delivery at hospital and invite religious leader to attend advocacy activities is necessary as well.