甘肃省农村地区基层医生妇女保健服务能力现状与提升对策研究

Study on the current status and improvement strategy of grass-roots doctors service abilities for health care of women in rural areas of Gansu Province

[目的]了解甘肃省农村地区基层医生妇女保健服务能力现状,分析其能力特点和存在的主要不足并探讨对策。[方法]2020年8月,采取分层整群抽样的方法,选取甘肃省农村地区(临洮县、渭源县、会宁县)的基层卫生机构医生作为调查对象,利用自评方式开展线上问卷调查。问卷内容包括基层医生个人基本情况,妇女保健服务能力(包括计划生育及避孕指导、孕期健康指导、围绝经期综合征的预防与诊治、“两癌”筛查)。[结果]共回收问卷886份,有效问卷805份。调查对象中,基本具备计生指导能力的有698例(86.7%),具备孕期指导能力的有711例(88.3%),具备围绝经期综合征预防与诊治能力的有645例(80.1%),具备两癌筛查能力的有549例(68.2%)。[结论]甘肃省农村基层医生妇女保健中围绝经期健康和两癌筛查服务能力较低;女性基层医生基本具备妇女保健服务能力的比例高于男性;农村基层医生队伍结构需要优化,尤其是村卫生室医生,女性医生不足,年龄结构偏大,不利于妇女保健服务提供。

Objective To understand the current status of grass-roots doctors service abilities for health care of women in rural areas of Gansu Province,to analyze the characteristics of their capacities and main deficiencies and to discuss countermeasures.Methods Doctors of primary-level medical institutions were selected from three rural areas of Gansu Province(Lintao County,Weiyuan County and Huining County)by stratified cluster sampling in August 2020.Online questionnaire survey was conducted by self-evaluation method.The questionnaire included the basic information of grass-roots doctors,service abilities for health care of women(involving the instruction of family planning and contraception,health guidance of pregnancy,prevention and diagnosis of perimenopausal syndrome and cervical cancer and breast cancer screening for women).Results A total of 886 questionnaires were collected and 805 were valid.Among respondents,698(86.7%)cases were basically competent in family planning instruction,711(88.3%)cases with the ability to give pregnancy guidance,645(80.1%)cases with the ability to prevent and diagnose perimenopausal syndrome,and 549(68.2%)cases with the ability to screen for cervical cancer and breast cancer.Conclusions Grass-roots doctors service abilities for health care of women are low in perimenopausal care and screening for cervical cancer and breast cancer in rural areas of Gansu Province.The proportion of female grass-roots doctors with basic ability to provide women's health care services is higher than that of male doctors.The structure of grass-roots doctors in rural areas needs to be optimized,especially those in village clinics,where there are in shortage of female doctors and their older age hinder the provision of women's health care services.