湖南省医疗保健机构新生儿早期基本保健技术服务现状调查

Investigation on early essential newborn care service in medical institutions of Hunan province

目的了解湖南省医疗保健机构新生儿早期基本保健服务现状,为开展有针对性的新生儿保健干预提供依据。方法采用随机抽样方法,于2017年11-12月抽取湖南省长沙市和株洲市各4所助产机构的住院产妇进行问卷调查,收集分娩期间新生儿早期基本保健服务措施的开展情况。采用SPSS 23.0统计软件进行数据分析,比较不同级别医院服务措施开展率的差异。结果720例产妇中41.8%的产妇表示在新生儿出生后立即进行了母婴皮肤接触,但仅有28.1%的皮肤接触持续时间在90 min及以上。新生儿出生24 h后洗澡的占42.3%。86.1%的新生儿在停止皮肤接触前完成首次母乳喂养,71.5%的新生儿出院前喂养方式为纯母乳喂养。接受延迟断脐(断脐时间不早于生后1 min)的新生儿占94.8%。市级机构大多数干预措施的实施率均高于县级机构。结论湖南省助产机构的新生儿早期基本保健技术实施现状与世界卫生组织的建议存在差距,应加强宣传和培训,促进医务人员对新生儿早期基本保健措施相关知识和技能的了解与应用。

Objective To investigate the current status of early essential newborn care and related services in medical institutions of Hunan province,so as to provide basis for developing targeted intervention.Method Random sampling method was used.A questionnaire survey was conducted among randomly sampled hospitalized pregnant women in four midwifery health facilities of Changsha and four midwifery health facilities of Zhuzhou from November to December in 2017.The information of newborn health care service at the time of delivery were collected through interview.SPSS 23.0 was used to conduct all analysis and services measures in different level of facilities were compared.Result Among the 720 participants,41.8%indicated that their newborns contacted with maternal skin immediately after birth,but the ratio of skin-to-skin contact more than 90 minutes was only 28.1%.42.3%newborns took a bath within 24 hours after birth.Rate of Early initiation of breastfeeding before stopping the skin contact was 86.1%.71.5%newborns were exclusively breastfed before discharge.94.8%newborns accepted delayed umbilical cord severing(no earlier than postnatal 1 min).The implementation rate of most interventions was higher at the municipal level than that at the county level.Conclusion There are gaps between the current early essential newborn health care in health facilities of Hunan province and the WHO recommendations.Early essential newborn care should be promoted and trained,which helps to improve the understanding and the practical application of relevant knowledge and skills among medical staffs.