孟连县基本公共卫生服务实施情况及其影响因素分析

Implementation and Influencing Factors of Essential Public Health Services in Menglian

目的：了解孟连县基本公共卫生服务实施情况，分析其主要影响因素。方法2012年9月，问卷调查分层随机抽取的孟连县3个基层医疗卫生机构2011年度基本公共卫生服务实施情况及其卫生技术人员的评价。结果2011年度，孟连县调查地区传染病疫情、突发公共卫生事件和卫生监督协管信息报告率均达到100%，绝大部分疫苗接种率达到90%以上，0～6岁儿童、孕产妇、老年人、高血压患者、2型糖尿病患者和重性精神疾病患者的健康管理服务率较高（约85%），但健康档案建档率（60%～70%）、高血压患者血压控制率（约50%）、2型糖尿病患者血糖控制率（55%～70%）和重性精神疾病患者稳定率（50%～60%）偏低，存在着县城、近郊、远郊实施不均衡情况。人力资源不足、设备不足或闲置、服务机构职责定位不清、农村居民不配合和不良生活习惯是影响当地基本公共卫生服务的主要因素。结论孟连县多项基本公共卫生服务的实施情况较好，培训人才、激活闲置设备、居民支持、健康教育等有助于推进基本公共卫生服务。

Objective To assess the implementation of essential public health services （EPHS）, and determine the main influencing factors for EPHS in Menglian. Methods In September 2012, the questionnaire survey method was employed to collect the data of EPHS implementation in 2011 in three community medical institutes and the EPHS evaluation of health staff sampled by stratified random sampling in Menglian. Results In 2011, the report rates of infectious diseases epidemics, public health emergencies and health inspection were all 100%, the inoculation rates of most vaccines were over 90%,and the health management rates of the children aged 0 to 6 years,pregnant and lying-in woman,aged population,hypertensives, type 2 diabetes patients and serious psychotics were high （about 85%） . The establishment rate of heath archives （60%to 70%）,the controlling rates of blood pressure in the hypertensive population （about 50%）, the rates of glycemic control in type 2 diabetes patients （55%to 70%） and the steady rates of serious psychotics （50% to 60%）, however, were low. The implementation of EPHS was unbalance among towns, suburbs and outer suburbs. The main factors that influenced the EPHS implementation were inadequate human resources, insufficient or unused health devices, ambiguous responsibilities among the health institutes, non-cooperative behaviors, and unhealthy living habits in rural residents. Conclusions The implementation of many EPHS items is good. For promoting EPHS,it is necessary to train human resources,activiate unused health devices,get support of residents and carry out health education.