中国碘缺乏病(IDD)监测方案评估的定性研究

A qualitative study on evaluation of national iodine deficiency disorders(IDD) surveillance plan in China

目的探讨《全国碘缺乏病监测方案(试行)》的管理、实施、效果和可能存在的问题,为我国完善碘缺乏病(iodine deficiency disorders,IDD)监测方案、最终消除IDD提出建议和科学依据。方法选取新疆维吾尔自治区、西藏自治区、甘肃省、山东省、河北省、广东省、吉林省、四川省以及云南省为研究现场,对不同工作层面的IDD防治工作人员进行个人深入访谈。结果 IDD监测方案的实施促进了我国IDD监测体系的完善,为消除IDD做出了巨大的贡献,各级卫生行政部门及监测单位基本能够按照监测方案的要求开展监测工作,但监测过程中重点抽样监测与随机抽样监测的时间间隔短、重点抽样监测抽样范围规定死板、高危监测范围扩大化、各部门间缺乏配合以及全国碘盐监测管理信息平台不稳定等问题在一定程度上影响了监测工作的顺利开展。结论我国IDD监测已经形成了一个有机的监测体系,《全国碘缺乏病监测方案(试行)》是可行、有效的,但是实施细则有待进一步完善。

Objective To evaluate the management, implementation, outcomes and contribution of the national iodine deficiency disorders（IDD） surveillance plan in China, and to find out the problems during implementation of the plan, so as to put forward suggestions for strategy improvement to eliminate IDD in China. Methods In-depth interview was applied among part of IDD control staff from different working levels in Gansu, Shandong, Hebei, Guangdong, Jilin, Sichuan and Yunnan provinces,as well as Xinjiang and Tibet Uygur Autonomous Regions of China. Results The implementation of IDD monitoring plan motivated the monitoring system improvement, and made great contributions to eliminating IDD. Health administrative departments and monitoring institutions had carried out all actions required by the surveillance plan. However, there were some problems that interfereneed IDD surveillance： the time interval was too short between key areas sampling and random areas sampling on monitoring iodized salt, the determination criteria of key areas sampling was unclear, the coverage of high-risk areas survey was too large, cooperation among different departments was not enough, and the national monitoring information management platform was unstable. ConclusionsThe IDD surveillance system had been set up in our country and the national IDD surveillance plan was feasible and necessary, but the implementation details should be further improved.