河北省赵县孕产妇和儿童健康管理现状研究

Survey on maternal and child health care management in Zhao County in Hebei Province

目的调查分析河北省赵县基本公共卫生服务项目中孕产妇和儿童健康管理实施现状,为改进服务质量提供研究资料和建议。方法根据国家基本公共卫生服务规范要求的服务内容设计调查问卷,主要包括体格检查、化验和咨询指导,现场观察乡镇卫生院妇幼保健人员的产前保健和儿童保健服务过程,并对保健人员进行访谈以了解其对自己的工作量、收入和提供喂养咨询指导的看法。结果调查共观察了88名孕妇的产前保健和194名儿童的保健服务。产前保健中有80%以上的孕妇进行了体格检查,但进行实验室化验者不足5%。保健人员很少提供咨询指导,没有孕妇得到母乳喂养方面的指导。儿童保健中98.5%的儿童测量了体重和身长,但分别只有6.2%和4.6%对照生长标准曲线进行了评价。只有21.6%的儿童家长接受了喂养指导。结论赵县基本公共卫生服务项目中产前保健和儿童保健的体格检查部分工作开展较好,但实验室化验和咨询指导方面的服务质量有待提高;保健人员反映工作量大、收入低,同时需要更多高质量的培训。

Objective To investigate the current status of maternal and child health care management provided by Basic Public Health Services Project in Zhao County in Hebei Province and to provide evidence-based recommendations on improving quality of health services. Methods Questionnaires were developed based on national guidelines on Basic Public Health Services and health facility survey was conducted in township hospitals, including physical check, laboratory test and counselling.Healthcare workers ’ services for pregnant women, children and their caregivers were observed, and some healthcare workers were interviewed to understand their perspective on workload, income and providing feeding counseling.Results Totally 88 pregnant women were observed in antenatal care and 194 children in child healthcare.For antenatal care, physical examinations were performed in more than 80%of observed consultations, but laboratory tests were provided in less than 5%. Counseling was rarely provided and none of the pregnant women was given counseling on breastfeeding.In child healthcare, children’ s weight and length were measured in 98.5% of cases, but only 6.2% and 4.6% of children’weight and length were assessed against the standards respectively.Only 21.6% of caregivers were provided with feeding counseling.Conclusion The physical examination of antenatal care and child health care in Zhao County is good, but the laboratory test and counseling service need to be improved.Healthcare workers consider that their workloads are heavy and incomes are low, and they need more high-quality training to provide feeding counseling.