京沪识别妇女健康需要权威程度

Authority of maternal health need information published by governmental and professional institutions in Beijing and Shanghai

目的分析京沪两地识别妇女保健需要权威程度的变迁情况及其与孕产妇死亡率的关系,并验证识别妇女保健公众需要权威程度量化评价的可行性。方法从研究机构、专业机构和政府3个层面出发,收集2000—2017年京沪两地发布的所有妇女保健敏感指标公开信息,运用描述性方法等分析两地发布妇女保健需要信息的变迁情况,并运用Spearman相关、单因素回归等分析识别权威程度与孕产妇死亡率的关系。结果上海政府等机构共同发布妇女健康敏感指标信息情况略优于北京,共同发布信息的问题数占比由2000年的30.0%提升至2017年的40.0%,北京则由2000年的0%提升至2017年的30.0%,其中育龄期保健类型上海三类机构共同发布信息的问题占比保持在40.0%水平,北京最高为20.0%,孕产期保健类型京沪共同发布情况2017年均为50.0%,但上海在2000年已发布问题占比已为25.0%;最终识别妇女健康需要的权威程度北京由40.5%提升至63.1%,上海由59.9%提升至69.9%。两地识别权威程度与孕产妇死亡率均存在负相关,其中上海的相关程度高于北京,相关系数为–0.710,北京为–0.484,京沪识别妇女健康需要权威程度与孕产妇死亡率均存在负影响关系,方程解释程度为37.2%和47.1%。结论适宜的妇保体系应加强政府等主要部门对健康需要的识别,上海识别妇女保健权威程度提升对健康结果作用略高于北京,专业机构应加强对妇女保健信息的识别与发布,促进妇女健康水平的提高。

Objective To analyze the authority of maternal health need information published by governmental and professional institutions and the relationship between the authority with maternal mortality in Beijing and Shanghai and to explore the feasibility for quantitative assessment on the authority of the information. Methods We collected all information on sensitive indicators of health needs among women in Beijing and Shanghai published by research, healthcare and governmental institutions between 2000 and 2017 by searching through all types of media. Descriptive methods were used to analyze and compare variations of the sensitive indicators in the two cities. Spearman correlation and univariate regression analysis were used to assess the relationship between authoritative degree of the information and maternal mortality.Results The maternal health need information published by all the institutions of the three categories in Shanghai were better than those in Beijing, with the increased proportion covering all the sensitive indicators from 30.0% in 2000 to 40.0%in 2017 for the released information of Shanghai and the increased proportion from 0% in 2000 to 30.0% in 2017 for the information of Beijing;the coverage proportions of all the sensitive indicators of childbearing period care remained at 40.0%for the information published by all the three-category institutions in Shanghai, but the highest proportion was only 20.0% in Beijing;while the coverage proportion of all the sensitive indicators of maternal health care was 25.0% in 2000 for the published information of Shanghai and the proportion was 50.0% in 2017 for both the published information of Shanghai and Beijing. The authority degree of the published information on recognized maternal health need increased from 40.5% in 2000 to 63.1% in 2017 in Beijing and from 59.9% to 69.9% in Shanghai. There was an inverse correlation between the authority degree of the published information on recognized maternal health need and maternal mortality in both the cities, with a higher correlation coefficient of – 0.710 observed in Shanghai than that of – 0.484 in Beijing. We also observed a negative impact of the authority degree of published information for identified maternal health needs on maternal mortality in the Beijing and Shanghai, with the interpretation percentages of 37.2% and 47.1% for the equations established. Conclusion Appropriate maternity insurance system should promote health need identification by major government departments. The positive effect of authority degree of published information for maternal health need identification on health outcomes was slightly higher in Shanghai than in Beijing. Efforts should be made by professional institutions in investigation and publication of maternal health information.