广东省孕妇学校现状及加强建设的策略分析

Strategies to strengthen the construction of pregnant women school in Guangdong province based on the analysis of its status quo

目的了解广东省助产机构孕妇学校健康教育服务利用、投入与管理现状,并针对发现的问题提出改进策略。方法定性与定量相结合的方法,通过2016年广东省统计年鉴获取广东省21个地级市人均GDP数据,通过2016年广东省产科质量年报表、妇幼保健服务体系基本情况年报表获取广东省21个地级市所有助产机构产妇数、孕妇学校听课产妇数和健康教育科人员数。通过半结构访谈的方式了解43家助产机构孕妇学校师资、资源支持和管理现状。数据处理和统计分析采用软件Excel 13.0和SPSS 21.0,采用集中指数和集中曲线对21个地级市孕妇学校健康教育服务利用和健康教育科人员进行公平性评价。采用单因素方差分析、卡方检验进行差异性分析。结果全省每千产妇孕妇学校听课人数为514.8人,每千产妇健康教育科人员为2.5人。21个地级市孕妇学校健康教育服务利用与健康教育科人员的集中指数分别为0.14和-0.14。43家助产机构孕妇学校投入与管理上:(1)人力资源:85.4%的机构师资为临床医生和护师,76.2%的机构中教师有接受过相关培训;(2)资源支持:7.9%的机构有其他单位赞助孕妇学校的运行,90%以上的机构基本配备孕妇学校教室,79.1%的机构有多媒体设备;(3)管理:56.1%的机构有制定孕妇学校管理方案,83.3%的机构有制定年度教学计划,仅18.6%的机构实现了信息智能化管理。结论广东省21个地级市孕妇学校教育服务利用和健康教育科人员分布存在不公平的现象。孕妇学校专项人员不足,且缺乏相关知识的统一培训。

Objective to understand the status quo of education services utilization,resource input and management of pregnant women school（PWS）,and propose the strategies for improvement based on the existing problems. Method Qualitative and quantitative methods were used. Per capita GDP data of 21 cities was collected through 2016 Guangdong Statistical yearbook. Indicators of the number of maternal,the number of maternal who attended PWS and the number of health educators of all the hospitals with qualified midwives in Guangdong were gained from 2016 Guangdong obstetrical quality survey and Guangdong maternal and child health care service system survey. Semi-structured interview was used to understand the teaching staff,resources support and management status of those 43 hospitals. Data process and statistical analysis were performed by Excel 13. 0 and SPSS 21. 0. Concentration index and concentration curve were used to evaluate the equity of PWS health education service utilization and health educators in 21 cities.One-way analysis of variance and Chi-square were used to test the difference on resource input and management of PWS. Result In Guangdong province,514. 8 pregnant women per thousand maternal attended PWS classes. There are 2. 5 health educators per thousand maternal. The concentration indexes of the PWS education service utilization and health educators are 0. 14 and-0. 14,respectively. As for the interviewed 43 hospitals,teaching staff in 85. 4% of the hospitals are clinicians and nurses. Teachers in76. 2% of the hospitals have received related training. 7. 9% of the hospitals received support from other institutions. 90% of the hospitals basically had classrooms for PWS education. 79. 1% had multimedia equipment. 56. 1% had PWS management protocol.83. 3% had annual teaching plans. Only 18. 6% realized information intelligence management. Conclusion PWS health education service utilization and health educators ＇distribution exist inequity in 21 cities of Guangdong Province. There is a short of PWS teachers,as well as lacking systematic training for them. Suggestions for improvement are as follow,（1）advocate hospitals and maternal pay more attention to the PWS health education and promote maternal and child health.（2） increase the input of PWS teaching staff and offer more training for them.（3） innovate PWS health education and management models.