云南省边远山区保山市预防接种单位现况和接种服务模式分析

Status of immunization units and immunization service modes in Baoshan city,a remote mountainous area of Yunnan province

目的了解云南省保山市预防接种单位现状、儿童家长对预防接种服务满意度情况,探索适合边远山区的接种服务模式。方法通过中国免疫规划信息管理系统收集保山市所有预防接种单位信息。采用分层整群随机抽样方法抽取全市5个县15个乡45个村的815名6月龄-3岁常住儿童家长,对预防接种服务满意度进行调查。结果保山市现有992个预防接种单位,其中村级903个、乡级52个、产科37个。在乡村级接种单位中,定点、定点+入户接种分别占90.16%、9.84%;日、月接种分别占48.80%、51.20%;平均每个接种单位的服务人口为2 752人,服务半径中位数(P_(25)-P_(75))为6.0(3.0-8.0)km。全市有接种人员2 441名,平均每万服务人口9.29名,平均每个接种单位2.56名;中专学历占70.46%;临床专业占75.26%;无职称占82.14%。儿童家长对各项预防接种服务的满意度在64.66%(接种日设置)-92.76%(服务态度)之间,综合满意度为68.96%。结论保山市村级接种单位多,接种人员素质差,儿童家长对预防接种服务满意度低。云南省边远山区应实行以村级接种为主的服务模式。

Objective To assess the status of immunization units and parents＇ satisfaction with immunization services in Baoshan city of Yunnan province,and explore a suitable immunization service mode for remote mountainous areas.Methods Information from all immunization units in Baoshan was collected through the China Immunization Program Information Management System.A stratified cluster sampling method was used to select 815 parents of children aged from 6 months to 3 years from 45 villages of15 townships in 5 counties for investigating their satisfaction with immunization services.Results There was a total of 992 immunization units in Baoshan,including 903 village,52 township,and 37 maternity units.In township and village units,90.16% conducted fixed-site immunization and 9.84% conducted fixed-site and house-to-house immunization;48.80% and 51.20% conducted daily and monthly immunization,respectively.The average service population was 2 752 per unit,with a median（P25-P75） service radius of 6.0（3.0-8.0） km.There was a total of 2 441 immunization staff in Baoshan,9.29 per 10 000 population or 2.56 per unit.70.46% of staff had attained a secondary-school education;75.26% majored in clinical medicine;and 82.14% had no professional title.Parental satisfaction with immunization services ranged from 64.66%（immunization sessions） to 92.76%（service attitudes）,with an overall satisfaction of 68.96%.Conclusions There was a large number of village immunization units in Baoshan,with few qualified immunization staff and low parental satisfaction with immunization services.The primary immunization service mode should be based at the village level in remote mountainous areas of Yunnan.