我国各级妇幼保健机构孕前保健服务现况调查分析

Investigation and analysis of pre-pregnancy health care services in maternal and child health care institutions at all levels in China

摘要

目的 了解我国各级妇幼保健机构孕前保健工作现况,分析问题,为有针对性地提高我国孕前保健工作水平提供参考依据。方法 采用自行设计的孕前保健服务现况调查表,于2022年对全国31个省(自治区、直辖市)的省级、地市级和县区级妇幼保健机构开展多阶段分层随机抽样调查,共计调查了359家(省级31家、地市级93家、县区级235家)妇幼保健机构。结果 在调查的妇幼保健机构中,孕前保健门诊的开设比例为80.2%,省级、地市级和县区级妇幼保健机构孕前保健门诊开设比例分别为71.0%、65.6%和87.2%,差异有统计学意义(χ²=21.503,P<0.05);不同地区妇幼保健机构孕前保健门诊的开设比例也有统计学差异(χ²=15.051,P<0.05);96.7%以上的各级孕前保健门诊普遍可以提供孕前保健健康教育、孕前优生健康检查和孕前健康咨询指导等基本服务,86.4%以上的各级孕前保健门诊可以提供孕前风险评估服务,部分孕前保健门诊还开展了包括孕前心理保健、营养保健、运动保健、口腔保健和眼保健等内容在内的孕前保健特色服务;各级孕前保健门诊具备一定的服务能力,并建立了孕前保健多学科协作机制和团队。结论 各地积极开设孕前保健门诊,且均具备一定的服务能力.建议各级孕前保健门诊进一步丰富孕前保健特色服务项目和内容,建立并运行相关管理和工作制度,提供更加规范、系统的孕前保健服务.

Abstract

Objective To understand the current situation of pre-pregnancy health care in maternal and child health care institutions at all levels in China, analyze the problems, and provide reference for improving the level of pre-pregnancy health care in China. Methods Using a self-designed survey on the current status of pre-pregnancy health services, a multi-stage stratified random sampling survey was conducted in 2022 on maternal and child health institutions at the provincial, prefecture level, and county level in 31 provinces (autonomous regions, municipalities directly under the central government) in China. A total of 359 maternal and child health institutions (31 at the provincial level, 93 at the prefecture level, and 235 at the county level) were surveyed. Results Among the maternal and child health care institutions surveyed, the proportion of pre-pregnancy health care clinics was 80.2%. The proportion of pre-pregnancy health care clinics in provincial, prefecture level and county level maternal and child health care institutions was 71.0%, 65.6% and 87.2%, respectively, and the difference was statistically significant (χ²=21.503, P<0.05). The proportion of preconception care clinics in maternal and child health care institutions in different regions was also statistically different (χ²=15.051, P<0.05). More than 96.7% of pre-pregnancy health clinics at all levels can generally provide basic services such as pre-pregnancy health education, pre-pregnancy eugenic health examination, and pre-pregnancy health consultation and guidance. More than 86.4% of pre-pregnancy health clinics at all levels can provide pre-pregnancy risk assessment services. Some pre-pregnancy health clinics also carried out specialized pre-pregnancy health care services including pre-pregnancy psychological health care, nutritional health care, exercise health care, oral health care and eye health care. Pre-pregnancy health care clinics at all levels have certain service capabilities and have established multidisciplinary collaboration mechanisms and teams for pre-pregnancy health care. Conclusion Pre-pregnancy care clinics have been actively opened in various regions, and all of them have certain service capabilities. It is suggested that pre-pregnancy health clinics at all levels further enrich the characteristic service items and content of pre-pregnancy health, establish and operate relevant management and work systems, and provide more standardized and systematic prepregnancy health services.

关键词

妇幼保健机构 / 孕前保健 / 服务能力 / 现况调查

Key words

maternal and child health institution / pre-pregnancy health care / service ability / prevalence survey

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基金资助

国家重点研发计划(2022YFC2703801)

国家重点研发计划(2023YFC2705501)