贫困地区基层妇幼保健资源的研究

Research on Maternal and Child Health Resources in Poor Rural Areas

目的 分析卫生院在《母婴保健法》实施前后妇幼卫生资源的变化,提出完善贫困地区资源支持的政策建议。资料和方法 三峡库区2个贫困县中6个有代表性的乡镇。利用第二次国家卫生服务总调查和补充调查表格进行资料收集。结果 妇幼卫生服务专职或兼职工作的人数没有增加,且学历水平低。到2000年时业务培训达到平均每人3个月以上。妇幼资金主要来源于政府拨款、服务收费和外部援助,其中服务收费比较稳定且比例较大,政府拨款数量非常少。外部援助是临时性的,但推动作用明显。各种项目的设备支持改善了卫生院的服务能力和质量。结论 妇幼卫生人力的数量和质量有待提高。卫生院补偿机制不利于深入开展妇幼卫生服务。建议加强对贫困地区的妇幼卫生人力建设,改革服务补偿机制,通过财政机制向贫困地区倾斜,继续进行适宜技术设备的投入。

OBJECTIVE To illustrate changes of MCH resource in township before and after the Law implementation. Policy recommendations provided. MATERIALS AND METHODS Six represented townships in two poor rural county of Chongqing were selected. Institutional data survey was conducted based on design of Second National Health Survey as well as supplementary data enquires. RESULTS MCH workforce still kept same after the Law implemented. MCH staff received one month training per year and more opportunity of MCH training was available under special health projects. Govemment budget, service fee and external assistants were the three major financial resources of poor areas. Govemment subsides were limited because unsatisfied local economic development. External financial assistances could be viewed as a temporary resource. CONCLUSIONS Quality and quantity of MCH staffs were wished to improve. Current reimbursement scheme for THC seems to go against further improvement of MCH services,and reformation is recommended. Researchers provided suggestions on MCH workforce developemnt,financial scheme reform and continuously support on appropriate facilities for MCH service in poor areas.