脱贫农村地区基本公共卫生服务婴幼儿健康管理与早期发展相关性

Correlation between utilization of basic public health services for child health management and early childhood development among 6–24 month old children in poverty alleviation rural areas in Henan province:a cross-sectional study

目的 分析农村地区基本公共卫生服务儿童健康管理服务的利用与婴幼儿早期发展间的相关性。方法 于2023年5—6月在河南省部分脱贫农村地区采用多阶段抽样方法抽取2 559名6~24月龄婴幼儿进行现场问卷调查,利用logistic回归分析基本公共卫生服务儿童健康管理与婴幼儿早期发展相关性。结果 在2 330名有效研究对象中,15.19%婴幼儿被检出存在早期发展迟缓高风险,其中,7~8月龄为19.82%,9~10月龄为17.56%,21~22月龄为22.4%,23~24月龄为27.17%;66.87%利用过基本公共卫生服务儿童健康管理,利用亚组中检出早期发展迟缓高风险率为13.22%,低于未利用亚组中19.17%高风险检出率。多因素回归分析结果显示,在控制其他因素后,基本公共卫生服务儿童健康管理利用与婴幼儿出现早期发展异常高风险呈现负相关关系(OR=0.76,95%CI=0.58~0.99)。结论 我国仍需更加关注脱贫农村地区婴幼儿早期发展落后情况,改进和完善农村地区基本公共卫生服务有助于促进儿童服务供给和提高我国农村地区儿童早期发展水平。

Objective To analyze the relationship between the utilization of basic public health services for child health management and the early development of infants and young children in rural areas.Methods From May to June 2023,we conducted an on-site,face-to-face survey of 2559 caregivers of rural children aged 6–24 months recruited through multistage sampling in 4 national and 4 provincial poverty alleviation counties in Henan province.Relevant child data were collected using a self-developed questionnaire and the Ages and Stages Questionnaires–Third Edition(ASQ-3).Multivariate logistic regression was used to analyze the association between basic public health services for child health management and children's early development.Results Of the 2230 children with valid information,15.19%were considered to be at high risk of early developmental delay,and the proportions at high risk were 19.82%,17.56%,22.40%,and 27.17%for children aged 7–8,9–10,21–22,and 23–24 months,respectively.Overall,66.87%of children were reported to have used basic public health services for child health management.The proportion of children at high risk of early developmental delay was lower among those who used basic public health services for child health management than among those who did not(13.22%vs.19.17%).The results of multivariate logistic regression analysis showed that,after controlling for potential confounders,the use of basic public health services for child health management was significantly negatively associated with high risk of early developmental delay in infants and young children(odds ratio=0.76,95%confidence interval:0.58–0.99).Conclusion In China,more attention should be paid to the lagging early development of infants and young children in poverty-alleviated rural areas,and improving and perfecting basic public health services in rural areas can help promote the provision of children's services and improve the level of early childhood development of rural children.