农村妇女主任对当地卫生机构孕产妇保健服务的评价及其影响因素

Evaluation on maternal health services of local health institutions in poor rural areas of China and its influencing factors: View of village women representatives

目的:研究我国贫困农村地区妇女主任对当地不同卫生机构孕产妇保健服务(医疗设备、医务人员技术水平和态度)的满意度评价及影响其评价的相关因素。方法:自行设计问卷,采取整群分层随机调查方法,选取四川、甘肃和云南3省,14县(区),120个乡镇,993个农村的妇女主任作为调查对象,就其对当地不同卫生机构(村卫生室、乡镇卫生院、县妇幼保健站、县医院)孕产妇保健服务评价进行调查,并基于Ordered Logit模型分析影响村妇女主任评价的因素。结果:在医疗设备和医务人员技术水平方面,卫生机构的级别越高,村妇女主任对其评价越好。在医务人员态度方面,卫生机构越基层,村妇女主任对其评价越好。影响村妇女主任对不同卫生机构医疗设备、医务人员技术水平和态度评价的相关因素包括本村孕产妇保健基本情况、村妇女主任个人特征、村级社会经济情况。结论:农村妇女主任对当地不同卫生机构提供的妇幼保健服务总体较为满意,影响村妇女主任对卫生机构医疗设备、医务人员技术水平和态度评价的相关因素因卫生机构的层级而异。通过提高农村基层卫生机构孕产妇保健服务的医疗设备和技术水平、改善县级卫生机构医疗人员的服务态度、加大农村孕产妇保健服务的供给力度、重点扶持农村妇女主任开展孕产妇保健工作、强化农村妇女主任孕产妇保健知识的宣传和培训以提高农村妇女主任对不同卫生机构的满意程度。

Objective： To evaluate the satisfaction of village women representatives with the maternal health （MH） services in poor rural areas of Southwest China and identify related influencing factors. This paper focused on three aspects of MH services （medical equipment, technical skills and attitudes） provided by four types of local health institutions （village clinics, township health centers, county maternal and child health stations, and countyhospitals）. Methods： A total of 993 village women representatives from 993 villages were selected from 120 townships in 14 counties in the provinces of Siehuan, Gansu, and Yunnan by stratified sampling. The satisfaction of village women representatives was investigated using questionnaires developed by the authors themselves. Influencing factors of satisfaction with medical equipment, technical skills, and attitudes were analyzed by Ordered Logit Model. Re- suits： The higher the level of local health institutions was, the more satisfied were village women representatives with medical equipment and technical skills. Conversely, the lower the level of local health institutions was, the more sat- isfied were village women representatives with the attitudes of hospital staff. Influencing factors with the satisfaction of village women representatives include the basic situation of village maternal heahheare, the personal characteristics of women representatives, and the village＇s social economic situation. Conclusion： Overall, village women representa- tives were satisfied with maternal services provided by local health institutions. Influencing factors with women representatives＇ satisfaction with the medical equipment, technical skills and attitudes of hospital staff varied in differ- ent levels of health institutions. Efforts should be made to improve the medical equipment and technical skills of rural MH services at the village and township levels, as well as medical attitudes at the county level; the supply of rural MH services should be expanded to support village women representatives＇ work in rural MH services and strengthen training to improve satisfaction with local health institutions.