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目的评价上海市松江区基本妇幼保健服务项目的效果,为有效提高妇幼保健服务的利用提供依据。方法本项目以上海市松江区基本儿童保健服务利用者为实施对象。调查对象为调查时间内区内15个社区卫生服务中心接受基本儿童保健服务的1岁~1岁半儿童母亲。2013年3月实施项目,同年6-7月进行基线调查,措施主要为0~6岁儿童免费体检。2014年7-9月进行终末调查,分析项目实施前后项目知晓率和基本儿童保健服务利用情况的差异。结果项目实施前后,儿童建卡率分别为87.5%、92.2%,儿童1岁以内≥4次体检率分别为86.8%、92.0%,项目知晓率分别为62.6%、75.9%,主要体现在非户籍人群上升显著。多因素Logistic回归发现项目知晓和项目实施均对儿童1岁以内≥4次体检率有统计学意义,OR分别为4.126(P<0.001)、1.875(P=0.014)。结论项目对提高基本妇幼保健服务利用有一定的效果,其中非户籍人口的提高更为显著。但今后仍需提高项目的知晓率,改善补偿方式,提升服务质量。
Objective To evaluate the effect of basic maternal and child health care services in Songjiang District of Shanghai and provide the basis for effectively improving the utilization of maternal and child health services. Methods This project is targeted at the users of basic child health services in Songjiang District, Shanghai. The respondents were mothers of 1-year-old and 1-year-old half-mothers who received basic child health services from 15 community health service centers in the district during the survey period. The project was implemented in March 2013 and the baseline survey was conducted in June-July of the same year. The measures are mainly free medical examination for children aged 0-6 years. From July to September 2014, a terminal survey was conducted to analyze the difference between the project awareness rate and the utilization of basic child health services before and after the implementation of the project. Results Before and after the implementation of the project, the rate of establishing cards for children was 87.5% and 92.2% respectively. The rate of physical examination ≥ 4 times for children younger than 1 year were 86.8% and 92.0% respectively. The awareness rates of the projects were 62.6% and 75.9% respectively, mainly due to non-household registration The crowd increased significantly. Multivariate Logistic regression found that both the awareness of the project and the implementation of the project were statistically significant for ≥4 physical examinations within 1 year of age, with odds ratios of 4.126 (P <0.001) and 1.875 (P = 0.014), respectively. Conclusion The project has some effects on improving the utilization of basic maternal and child health care services, among which the increase of non-household population is more significant. However, in the future, we still need to raise awareness of the project, improve the compensation method and improve the quality of service.