降低农村边远贫困地区产后出血死亡的社区干预措施研究

The study on quarter interruption measures to decrease post-partum, hemorrhage mortality in the remote and poverty urban region

广西壮族自治区的３０个老、少、边、山、穷县，自１９９５年开始实施世行贷款的综合性妇幼卫生保健项目，在项目起始阶段进行基础调查时，结合项目实施开展了针对产后出血社区干预措施的研究，以项目为载体，逐步采取强化政府行为、依法提高产科质量和农村住院分娩率、实施母亲安全等一系列综合有效的社区干预措施，取得了显著项目效果和研究成果。据统计，项目基础调查时孕产妇死亡率为２３０．８４／１０万，死亡３９１人，其中因产后出血死亡１４０人，占孕产妇死亡的３７．００％，是孕产妇死亡的首位死因。到２０００年３０个项目县的孕产妇死亡率由２３０．８４／１０万下降到６０．４１／１０万，死亡人数从项目实施前的年死亡３９１人下降至２０００年的８４人，其中产后出血死亡人数从项目实施前的年死亡１４０人减少到２０００年的１０人，构成比由 ３７．００％下降到１２．３５％；６年间３０个县共减少了孕产妇死亡１ ２３４人，其中减少产后出血死亡共６８７人，使广西区降低孕产妇死亡提前两年达到了国家《两纲》的目标。说明利用项目进行产后出血死亡的社区干预措施研究的成果和经验，在西部地区是有应用价值的。

old-revolution, minority nationality, remote, mountain , poverty counties of Guangxi had begun to carry out general MCH item of world bank loan since 1995. In the period of the basic investigation of item initial stage, had developed the study of post-partum, hemorrhage quarter interrupt measure, had made consolidate government action step by step, raised obstetric department quality and childbirth rate in hospital according to the law, carried out mother safety and so on serial general and effective measures made item effect and study results. In item basic investigate, the statistic results were that mortality of pregnant and gravida was 230. 84/1O×104 ,391 persons dead,140 cases died in post-partum hemorrhage was 37.00% of the total dead persons, it is the major dead cause. In 2000 ,pregnant and gravida mortality decreased from 230. 84/10×104,to 60. 41/1O×104 ,the amount of dead persons decreased from 391 persons per year to 84 persons per year, the amount of person died in post-partum hemorrhage was from 140 persons per year to 10 persons per year . the portion decreased from 37. 00% to 12. 35%. In the 6 years, pregnant and gravida in 30 counties decreased 1 234 persons, persons dead in post-partum hemorrhage was 687. It make the work to decrease pregnant and gravida mortality be earlier two years than planned to attain the demand of <two programs>. The results indicated that the achievement and experience of post-partum hemorrhage quarter interrupt measure study utilizing item were worth to use in west region