0~6岁儿童眼保健和视力检查服务现状及对策研究

Research on the current situation and countermeasures of eye health care and vision examination services for children aged 0−6 years

目的了解0~6岁儿童眼保健和视力检查服务现状,为相关部门提供决策依据。方法采用方便抽样方法,于2019年9—12月从北京市、安徽省、青海省抽取15家区县级妇幼保健院及基层卫生机构进行问卷调查,并采用现场观察及小组访谈的方式了解儿童眼保健服务现状及存在的问题等。结果被调查的区县级妇幼保健机构均配备了开展儿童眼保健服务的基本用房及设备;基层卫生机构均配备了开展儿童眼保健服务的基础设备,但有些设备陈旧破损、闲置未用。被调查机构儿童眼保健人员均不足,区县级妇幼保健院、社区卫生服务中心和乡镇卫生院的儿童眼保健人员分别占卫生技术人员的9.5%、5.5%和2.4%,不同类型卫生机构的儿童眼保健人员占比差异有统计学意义(χ^(2)=8.966,P=0.011)。社区卫生服务中心无眼科医生,该岗位由儿保人员兼职。被调查机构儿童眼保健人员接受上级指导及培训的机会普遍较少,年人均1~3次。各地儿童眼保健及视力检查服务覆盖率均在90%以上,但现场观察发现儿童眼保健人员操作技能尚不熟练、不规范。结论各卫生机构均需进一步完善儿童眼保健及视力检查服务设备,提高儿童眼保健人员的知识技能及服务质量。

Objective To investigate the current situation of eye health care and vision examination services for children aged 0−6 years,so as to provide evidence for policy-making.Methods From September to December 2019,15 county-level maternal and child health institutions and grassroots health facilities were recruited by convenient sampling from Beijing,Anhui,and Qinghai provinces.Questionnaire survey,on-site observation,and focus group discussions were used to investigate the current situation of eye health care and vision examination services for children. Results All maternal and child health institutions at district and county levelswere equipped with basic rooms and equipment. Grassroots health facilities were equipped with basic equipment, but some were old,damaged, and left unused. There was a shortage of children’s eye health care personnel. The percentage of children’s eye health carepersonnel in all health technicians at maternal and child health institutions, community health service centers, and township healthcenters were 9.5%, 5.5% and 2.4% respectively. The difference was statistically significant(χ^(2) = 8.966, P = 0.011). There were noophthalmologists at community health service centers, and child health care professionals would hold these posts concurrently.Children’s eye care personnel generally received less guidance and training from superiors, being 1 − 3 times/year/person. The coverageof children’s eye health and vision examination services in various regions had reached over 90%. However, on-site observation foundthat their operational skills were not proficient and standardized. Conclusion Health institutions need to further upgrade theirequipment of eye health care and vision examination, and to improve health personnel’s knowledge, skills, and quality of service.