降低贫困山区孕产妇死亡运作式研究——云南省贫困山区降低孕产妇死亡率干预研究

The running study on decreasing poverty mountain area pregnant and lying-in women mortality The distribution study on decreasing pregnant and lying-in women mortality of poverty mountain area in Yunnan province

目的 :为了寻求改善妇女保健服务 ,有效降低贫困山区孕产妇死亡的方法及措施。方法 :采用运作式研究等方法 ,2 0 0 0年 5月～ 2 0 0 2年 3月 ,选择我省孕产妇死亡率较高的贫困山区昭通市及经济条件、服务范围、地域环境不同的巧家县和昭阳区作为示范性运作研究的试点 ,通过自变量的调整及总结推广试点成功经验 ,对提高贫困山区妇女保健服务水平 ,降低全区孕产妇死亡率收到了较好的效果。结果 :孕产妇死亡率 2 0 0 1年与 1999年相比 ,昭通市下降了 69 77/10万 ,巧家县下降了 2 0 0 72 /10万 ,昭阳区下降了 83 15 /10万 ,实现了下降 1/2的目标 ,超额完成了预定目标。结论 :运作式研究的方法有助于强化管理及落实干预措施 ,定性 +定量 +运作式研究方法 ,有利于取长补短 ,发挥多种优势 ,增强研究工作的深度及广度 ;将开展形式多样、群众乐于接受的健康教育作为工作的先导 ,立足社区重点问题自变量的控制调整 ,加强高危孕产妇筛查、监护、管理和危急孕产妇的急救、推广适宜技术提高产科质量 ,减少产科出血 ;推行住院分娩限价收费、提高乡镇卫生院住院分娩率 ;简化贫困救助基金的申办程序 ;制定实施快速有效的呼救、运转、抢救规程 ;培训县、乡、村妇幼人员 ;强化分类督导 ,面向成果的管理和评估等方法和措?

Objective: To find out method and measurement to improve women health care service and decrease pregnant and lying in women in poverty mountain area efficiently. Methods: To select poverty mountain area Zhaotong city where the pregnant and lying in women mortality is higher and Qiaojia county and Zhaoyang district where the economy, service range, region environment are different as sample point, to increase women health care service level of poverty mountain area, spreading succeed experimental through adjustment and summary can do better effect on decreasing women health care service level and decreasing mortality. Results: Comparing the mortality of 2001 with that of 1999,Zhaotong city decreased 70 17/10×10 4 ,Qiaojia county decreased 200 72/10×10 4 ,Zhaoyang district decreased 83 15/10×10 4, fulfill the target to decrease 1/2, and complete the expected target. Conclusion: The running study method help to strength management and implement distribution measurement, quality +ration+ running study methods can overcome weak points by learning from strong points , give full play to superiority, strength work depth and scope, make various, acceptable health education as work guide , strength high risk pregnant and lying in women screening, lookout management and first aid, spread suitable techniques to increase obstetric department quality ,spread limited fee, height childbirth rate in county hospital, simply poverty help fund sequence, formulate rapid, effective calling, revolving, rescue rules, train county, country, village maternal and children care workers, the methods and measurements of results management and evaluation have better direction and actual action on decreasing poverty mountain area pregnant and lying in women mortality.