健康战略对京沪妇女保健职责明确作用分析

Role of health strategy on clarification of department responsibility in maternal health care in Beijing and Shanghai

目的评价健康战略前后京沪两地妇女保健工作职责清晰、可考核状况的差异,探讨健康战略对于提升各部门职责分工清晰、可考核程度的重要作用。方法系统收集2016-2017年所有涉及北京、上海妇女保健相关政策文件(北京232份文件、上海417分文件),摘录“任务”“职责”“考核”等字段内容,量化计算职责清晰程度与可考核程度。结果2016年健康战略实施后,北京和上海妇保工作职责清晰程度有明显上升,北京增长至57.8%,上海增长至62.7%,增长幅度均接近20%;然而两地职责可考核程度均无提升。结论健康优先战略显著提高京沪两地妇保工作的职责清晰程度,尤其是改善了关键支撑部门的职责清晰状况,但仍有待进一步清晰。健康战略的有效落实亟待进一步提高妇女保健工作的职责可考核程度。

Objective To compare differences in clarification and assessability of department responsibility in maternal health care in Beijing and Shanghai municipality before and after the initiation of the health strategy.Methods We systematically retrieved all maternal health care-related the policy documents issued by governmental agencies of Beijing(232 files)and Shanghai municipality(417 files)during 2016-2017.The texts of“task”,“responsibility”and“assessment”in all the documents were extracted for quantitative evaluation on the clarification and assessability of department responsibility in maternal health care.Results After the initiation of health strategy in 2016,the clarification of department responsibility in maternal health care was promoted in both Beijing and Shanghai remarkably,with about 20%increased clarity indexes up to 57.8%and 62.7%in Beijing and Shanghai municipality.However,no obvious variation in the assessability of the implementation of department responsibility was observed in the two municipalities.Conclusion After the initiation of health strategy,the clarification of department responsibility in maternal health care,especially the responsibility for key sectors,was significantly increased in Beijing and Shanghai municipality but the assessability of the implementation of the responsibility needs to be improved urgently in the two municipalities.