目的提高项目地区县级医疗机构产儿科人员新生儿窒息复苏能力,在试点地区建立包括政策、规章、人员和资金支持在内的医疗机构新生儿窒息复苏工作的长效机制。方法在中澳卫生与艾滋病项目确定的4个项目县开展项目活动。为实现项目目标,项目组计划实施了省级师资培训班、县级定期复训,建立院内新生儿窒息复苏领导小组制度,开展国家级和省级督导与评估,举办专家研讨会及经验交流会等22项子活动。项目结束后,采用随机对照的研究方法,选择4个对照县进行调查并与干预县进行比较。结果①政策影响方面:干预县新生儿科医生参加高危分娩术前讨论、分娩现场等待分娩、参加新生儿窒息病例评审等制度建立率均在90%以上,对照县均低于55%。项目省将中澳项目所引进的知识、管理制度和经验扩展到全省范围,产生深远的影响。②能力建设方面:干预县和对照县医务人员新生儿复苏知识平均得分分别为(9.19±1.18)分和(8.40±1.52)分(t=3.922,P<0.001),自信心平均得分分别为(57.33±2.50)分和(54.09±8.19)分(t=3.541,P=0.001);对照县医务人员“快速评估的四项内容”、“羊水污染且无活力是否需要立即气管内吸引胎粪”等核心知识的回答,正确率均低于70%,且均显著低于干预县。③临床效果方面:干预县新生儿窒息发生率由8.83%降至5.99%(χ2=11.300,P=0.001),因窒息死于分娩现场率由27.60/10万降至5.03/10万(χ2=3.142,P=0.076);对照县这两个率的变化均无统计学意义。结论中澳项目在政策影响、能力建设和临床效果等方面取得了显著成绩,不仅提高了医务人员新生儿窒息复苏的技术能力和自信心水平,降低新生儿窒息发生率和死亡率,而且促成项目省出台了一系列降低新生儿死亡的政策、规章和制度,以项目为契机促进妇幼卫生工作的全面发展和提高。 Objective To improve the capacity of neonatal asphyxia recovery of pediatric pediatricians in the medical institutions in the project area and establish a long-term mechanism for resuscitation of neonatal asphyxia in medical institutions, including policies, regulations, personnel and financial support in pilot areas. Methods The project activities were carried out in 4 project counties identified by the China-Australia Health and AIDS project. In order to achieve the project goal, the project team plans to implement the provincial-level teachers training classes, county-level regular rehabilitation training, the establishment of a hospital leading group system of neonatal asphyxia recovery, carry out national and provincial supervision and evaluation, hold expert seminars and exchange of experiences Other 22 activities. After the project was completed, a randomized controlled study was conducted to select four control counties for comparison and comparison with the intervention counties. Results ①Influence of policies: The intervention rate of neonate pediatricians participating in the preoperative discussion of high-risk labor, delivery site waiting for childbirth, participation in neonatal asphyxia case evaluation and other system establishment rates are above 90%, and the control county are less than 55%. The project provinces have extended the knowledge, management system and experience introduced by the Sino-Australian Project to the whole province and have a profound impact. (2) In terms of capacity building, the mean scores of neonatal resuscitation knowledge of medical staff in intervention counties and control counties were (9.19 ± 1.18) points and (8.40 ± 1.52) points respectively (t = 3.922, P <0.001) 57.33 ± 2.50) and (54.09 ± 8.19) points (t = 3.541, P = 0.001). The medical staffs in the control county, the four items of rapid assessment, and the need for immediate intratracheal ingestion of amniotic fluid Meconium "and other core knowledge of the answer, the correct rate was less than 70%, and were significantly lower than the intervention counties. ③ In clinical effect, the incidence of neonatal asphyxia in interventional counties decreased from 8.83% to 5.99% (χ2 = 11.300, P = 0.001), and the rate of death due to asphyxiation to delivery site decreased from 27.60 / 100000 to 5.03 / 100000 (χ2 = 3.142, P = 0.076). There was no significant difference between the two rates in the control county. Conclusion The China-Australia project has made remarkable achievements in terms of policy implications, capacity building and clinical effects. This not only improves the technical capacity and confidence of medical staff in resuscitation of neonatal asphyxia, but also reduces the incidence of neonatal asphyxia and mortality and contributes to the project The province has promulgated a series of policies, rules and regulations to reduce neonatal deaths and took the project as an opportunity to promote the all-round development and enhancement of MCH work.