上海市长宁区2011—2020年计划生育技术服务管理情况分析

Analysis on the management of family planning technology services during 2011‒2020 in Changning District of Shanghai

【目的】了解近10年上海市长宁区计划生育技术服务的情况,为进一步做好计划生育技术服务和管理提供依据。【方法】基于长宁区妇幼卫生工作报表,回顾性分析2011—2020年的计划生育手术、重点人群管理、手术质量管理、避孕咨询等情况。【结果】计划生育手术量下降,人工流产(人流)术量下降,中期引产术量下降,活产数下降,出生人流比下降;人流者以非本市已婚人群为主,19岁以下人流者主要为非本市未婚女性;新婚对象、社区避孕节育咨询服务量总体下降,产后避孕咨询指导水平有待提高;宫内节育器放置数、皮下埋置数减少,高效避孕方式可接受度有待提高;人流术后即刻放置宫内节育器率逐年提高;高危计划生育手术构成比总体下降,严重手术并发症依然存在。【结论】随着生育政策的调整,妇幼保健工作者要以计划生育技术服务对象需求为导向,加强对重点人群开展多形式的科普宣传,积极引导重点人群科学安排再生育;优化服务流程,加强技术人员技能培训,提高服务质量和水平,保障母婴安全。

[Objective]To determine the management of family planning technology services in Changning District of Shanghai over the past decade,and to explore the key populations and service patterns along with changing family planning policy,so as to provide evidence for further family planning services and management.[Methods]Based on the routine statistics,family planning surgery,management of key populations,management of surgery quality,and contraceptive counseling from 2011 through 2020 in Changning District were retrospectively reviewed.[Results]The number of family planning surgery,induced abortion,midtrimester induced abortion,live births,and birth to induced abortion ratio has decreased.Majority of those who received induced abortion were non-local married women,whereas those under 19 years were principally non-local unmarried ones.In total,contraceptive counseling decreased among newly married couples and in the community.Postpartum contraceptive counseling guidance remained at a low level.Furthermore,the number of IUD placements and subcutaneous implants has reduced,suggesting the acceptance of highly effective methods of contraception needs to be improved.The percentage of immediate IUD placement following induced abortion gradually increased.In addition,the percentage of high-risk family planning surgery showed a decreasing trend,however,serious surgical complications remained.[Conclusion]With the“universal two-child”policy,the number of family planning surgery,especially induced abortions,has decreased significantly.It warrants a demand-driven family planning services,including strengthening the multiple health education and promoting to having a second child for key populations.Moreover,we should optimize the service process,strengthen the professional training for relevant clinicians and staff,and improve the quality of services for ensuring the mother and child health.