上海市长宁区产后家庭访视服务现状的质性研究

Qualitative Research on the Situation of Postpartum Home Visit by Community Health Providers in Changning District,Shanghai

目的:了解上海市长宁区产后家庭访视服务的现状、存在的问题及困难,为提高产后访视服务质量提供参考。方法:2018年3月-2019年3月非参与式观察44名社区产后访视人员家庭访视过程,了解其服务质量;组织产后访视人员焦点小组讨论4组共30人,开展相关管理者个人深入访谈22人,了解产后访视服务中遇到的困难和对于服务质量改善的建议。结果:长宁区社区产后访视人员结构欠优化、配置不足、综合服务能力有待加强;访视服务中的困难主要有产妇信任不足、入户困难、服务单一、私立行业的冲击等。结论:政府应调整政策,吸引优秀专科医师加入产后保健队伍;加强规范化培养,提升访视人员临床知识及技能水平;拓展特色服务内容,增强竞争力;提高入户访视覆盖率,维护母婴健康。

Objective:To understand the situation,problems and difficulties of postpartum home visitation in Changning District in Shanghai,and to provide reference for improving the service quality of postpartum visits.Methods:From March 2018 to March 2019,44 service providers were followed into the postnatal women's home for non-participatory observation of the delivery of postpartum visit service to collect the information of quality.Four focus group discussion among service providers and 22 individual in-depth interviews among service managers were developed to discuss the problems existing in the postpartum home visits and suggestions for improving the quality of services.Results:The postpartum home visit personnel allocation in Changning district was not optimized and insufficient.The comprehensive service abilities were weak.The difficulties included the lack of maternal trust,hard to enter the family,single service and impact of private institutions,etc.Conclusion:The government should adjust policies to attract excellent professional doctors to join,strengthen standardized training to improve the knowledge and skills level of visitors,expand the characteristic service content to enhance competitiveness and improve the coverage of home visits to maintain the health of mothers and infants.