京沪妇女保健中长期目标的合作力量研究

Research on Power of Alliances Covered by Strategic Planning of Maternal Health Care in Beijing and Shanghai

目的:比较京沪妇女保健领域中长期目标相关各方程度变化,分析其异同,明确中长期目标战略规划基本点妇女保健和妇女健康的意义,初步探讨相关各方程度的量化方法。方法:收集2000-2017年所有涉及京沪两地妇女保健问题的中长期发展规划,运用专家咨询法量化涉及相关各方程度,运用Spearman相关系数分析涉及相关各方程度与孕产妇死亡率之间的关系。结果:2000-2017年京沪两地妇保领域激励机制覆盖程度逐渐完善。2017年两地差异不明显(72.34%vs66.66%),其中,基层卫生服务机构京沪差异明显(91.88%vs68.35%),两地都缺少针对更年期保健的激励机制。两地孕产妇死亡率与覆盖程度呈显著负相关( P < 0.01 ),上海覆盖程度对孕产妇死亡率影响的解释程度为22.4%。结论:建立激励机制是妇女保健体系职能有效落实的基础;京沪激励机制覆盖程度对健康结果的影响存在差异;激励机制覆盖程度可以量化比较。

Objective: The aim of this paper is to measure the power of alliances which are involved by the strategic planning of maternal health care,analyse the similarities and differences,clarify the significance of women's health care and women's health in the medium and long-term strategic planning and discuss the quantitative method of the degree of related parties . Methods: The public strategic planning documents on maternal health care in Beijing and Shanghai from 2000 to 2017 were collected. Delphi method was used to measure the degree of related parties. Spearman's rank correlation coefficient was used to analyze the relationship between the measurement and maternal mortality. Results: The incentive in maternal health care in Beijing and Shanghai had improved gradually from 2000 to 2017. In 2017, both of them are not in the sufficient level,and the difference between them is narrow. In 2017, there was little difference between the two places (72.34% vs 66.66%), among which, there was a significant difference between primary health service institutions in Beijing and Shanghai (91.88% vs 68.35%), and there was a lack of incentive mechanism for menopause care in both places.There was a significant negative correlation between the measurement and MMR ( P <0.01).The effect of Shanghai coverage on maternal mortality was explained by 22.4%. Conclusion: The Power of alliances is germane to the goal achievement of coordination and the measurement is reliable and useful.The establishment of incentive mechanism is the basis for the effective implementation of women's health care system.The coverage of incentive mechanism has impact on health outcomes in Beijing and Shanghai.The coverage of incentives can be compared quantitatively.