京沪妇女保健组织体系完善程度

Completeness of maternal health care system in Beijing and Shanghai: a literature study

目的比较京沪两地妇女保健组织体系完善程度的差异,明确其意义,探索对其量化评估的可行性。方法系统收集(穷尽)2000—2017年京沪两地妇女保健公开文件资料,北京232份,上海417份,从中提取并量化相关信息,评价两地妇女保健组织体系完善程度。利用Spearman相关、线性回归,分析其与孕产妇死亡率的关系。结果2000—2017年,京沪两地妇女保健组织体系完善程度分别由32.4%、41.1%上升至50.6%、64.6%,上海优于北京。其中组织架构健全程度达到较高水平,而组织体系协调权威程度、各方职责明确程度均处于较低水平。京沪两地组织体系完善各指标与孕产妇死亡率均呈负相关。结论两地组织体系逐步完善,对妇保健康结果的促进逐步显现,但两地仍需重点加强组织体系协调权威、职责明确方面的建设;适宜的妇女保健组织体系应组织架构健全、协调权威、各方职责明确;本研究所探索采用的量化评价方法具备可行性和可推广性。

Objective To compare the disparity in the completeness of maternal health care(MHC) system between Beijing and Shanghai and to explore the feasibility of quantitative evaluation on the degree of the completeness.Methods We systematically and extensively collected documents and materials on MHC issued by administrative agencies of Beijing and Shanghai municipality published during 2000-2017. Then we extracted relevant information from 649 retrieved documents(232 relevant to Beijing and 417 to Shanghai) and analyzed the information quantitatively to assess the completeness of MHC system in the two municipalities. Spearman correlation and linear regression analysis were used to analyze the relationship between the completeness of MHC system and maternal mortality rate(MMR). Results The relevant information-derived index for the completeness of MHC system increased from 32.4% in 2000 to 50.6% in 2017 in Beijing municipality;while, the index increased from 41.1% to 64.6% in Shanghai, respectively. For the two municipal MHC systems, the framework completeness was at a high level but the coordination and responsibility assignment among various functional institutions of the system were at a low level. There was an inverse correlation between the index for the completeness of MHC system and MMR in the two municipalities. Conclusion The completeness of maternal health care system were improved and the improvement facilitated maternal health care practice in Beijing and Shanghai gradually during 2000-2017;but the coordination and responsibility assignment among various functional institutions of the system should be promoted. The study verified the feasibility of quantitative assessment on the completeness of maternal health care system.