Ebrahim Shahul H, Lo Sue Seen-Tsing, Zhuo Jiatong, Han Jung-Yeol, Delvoye Pierre, Zhu Li
Centers for Diseases Control and Prevention, Atlanta, GA, 30333, USA.
Matern Child Health J. 2006 Sep;10(5 Suppl):S37-42. doi: 10.1007/s10995-006-0096-9. Epub 2006 Jun 9.
Globally, maternal and child health faces diverse challenges depending on the status of the development of the country. Some countries have introduced or explored preconception care for various reasons. Falling birth rates and increasing knowledge about risk factors for adverse pregnancy outcomes led to the introduction of preconception care in Hong Kong in 1998, and South Korea in 2004. In Hong Kong, comprehensive preconception care including laboratory tests are provided to over 4000 women each year at a cost of $75 per person. In Korea, about 60% of the women served have known medical risk history, and the challenge is to expand the program capacity to all women who plan pregnancy, and conducting social marketing. Belgium has established an ad hoc-committee to develop a comprehensive social marketing and professional training strategy for pilot testing preconception care models in the French speaking part of Belgium, an area that represents 5 million people and 50,000 births per year using prenatal care and pediatric clinics, gynecological departments, and the genetic centers. In China, Guangxi province piloted preconceptional HIV testing and counseling among couples who sought the then mandatory premarital medical examination as a component of the three-pronged approach to reduce mother to child transmission of HIV. HIV testing rates among couples increased from 38% to 62% over one year period. In October 2003, China changed the legal requirement of premarital medical examination from mandatory to "voluntary." This change was interpreted by most women that the premarital health examination was "unnecessary" and overall premarital health examination rates dropped. Social marketing efforts piloted in 2004 indicated that 95% of women were willing to pay up to RMB 100 (US$12) for preconception health care services. These case studies illustrate programmatic feasibility of preconception care services to address maternal and child health and other public health challenges in developed and emerging economies.
在全球范围内，孕产妇和儿童健康面临着因国家发展状况而异的各种挑战。一些国家出于各种原因引入或探索了孕前保健。出生率下降以及对不良妊娠结局风险因素的认识不断提高，促使香港在1998年、韩国在2004年引入了孕前保健。在香港，每年为4000多名妇女提供包括实验室检查在内的全面孕前保健，每人费用为75美元。在韩国，接受服务的妇女中约60%有已知的病史风险，面临的挑战是将该项目扩大到所有计划怀孕的妇女，并开展社会营销。比利时成立了一个特别委员会，为在比利时法语区试点孕前保健模式制定全面的社会营销和专业培训战略，该地区有500万人，每年有5万例分娩，利用产前保健和儿科诊所、妇科部门以及遗传中心。在中国，广西省在寻求当时强制性婚前医学检查的夫妇中试点开展孕前艾滋病毒检测和咨询，作为减少艾滋病毒母婴传播的三管齐下方法的一部分。夫妇中的艾滋病毒检测率在一年时间内从38%提高到了62%。2003年10月，中国将婚前医学检查的法律要求从强制性改为“自愿性”。大多数女性认为这一变化意味着婚前健康检查“没有必要”，总体婚前健康检查率下降。2004年试点的社会营销努力表明，95%的女性愿意为孕前保健服务支付最高100元人民币（12美元）。这些案例研究说明了孕前保健服务在解决发达经济体和新兴经济体中的孕产妇和儿童健康及其他公共卫生挑战方面的项目可行性。
