新疆免疫规划规范化管理专项整治成效分析

Performance analysis of standardized management of immunization programs in Xinjiang

目的进一步加强免疫规划规范化管理,切实改进工作中的薄弱环节并解决突出问题,提高规范化、精细化管理水平,丰富和完善新疆免疫规划管理工作。方法采用理论分析与实证分析相结合的方法。结果全疆免疫规划规范化管理专项整治初见成效,全疆预防接种服务单位均有不同程度的增加及网络服务模式的改变,差异有统计学意义（χ^2=47.76,P〈0.001）,其中城镇社区卫生服务中心/站累计报告新增178个,农牧区以集中接种为主的村级接种点累计报告新增1 579个,农牧区至少每半月开展一次接种活动的村级接种点累计报告新增2 112个;全疆从事预防接种的人员共有18 110人,其中包括执业医师1 049人、执业助理医师903人、护士5 114人、乡村医生11 044人,县、乡和村级卫生机构从事预防接种人员的构成差异有统计学意义（χ^2=5 649.23,P〈0.001）,其中县、乡级人员构成主要以护士为主,村级人员构成主要以乡村医生为主;2015年全疆入托入学查验证工作较2014年有所提高,漏证和漏种率均有不同程度的降低,但全疆免疫规划基础性管理工作仍有待加强,规范化管理水平较低,部分地区常规免疫服务网络不健全,服务能力不足,存在一定免疫空白人群。结论应继续在全疆范围内开展免疫规划规范化管理专项整治活动,并围绕＂责任明确、底数清楚、数据真实、管理规范、保障有力、效果明显＂几方面梳理和整改问题。

Objective To enhance the standard management of immunization programs, effectively resolve the outstanding problems and weak links in the work, improve the management level, in order to enrich and improve the management of immunization in Xinjiang. Methods Theoretical analysis and empirical analysis were taken to carry out evaluation on the management. Results This activity displayed initial effects. The vaccination service units in Xinjiang increased and their network service models were also changed, with statistical difference（χ^2=47.76, P〈0.001）. One hundred and seventy-eight urban community health service centers increased, and 1 579 centralized vaccination sites were reported increase newly in agricultural and pastoral areas. There were increased 2 112 vaccination sites developing a vaccination activity every half a month at least in agricultural and pastoral areas. Totally 18 110 persons engaged in vaccination in Xinjiang, including 1 049 practitioners, 903 practicing physician assistants, 5 114 nurses, 11 044 rural doctors. The constituent of the personnel was statistically different（χ^2=5 649.23, P〈0.001）. The work of checking verification in nursery school was better in 2015 than in 2014,and the leak rate of verification and vaccination declined. However, the basic management of immunization program in Xinjiang should be enhanced. There was still low level of standardized management, imperfect routine immunization, and inadequate service capabilities, and a certain population immunity gap still existed. Conclusions Special rectification activities of standardized management of immunization programs should be conducted in Xinjiang by sticking to definite responsibility, clear background, real data, normalized management, effective support and obvious effect.