Tian Lichun, Li Jianghong, Zhang Kaining, Guest Philip
The Institute for Health and Development Studies, Kunming Medical College, Renmin West RD 191, Kunming 650031, China.
Health Policy. 2007 Dec;84(2-3):284-97. doi: 10.1016/j.healthpol.2007.04.008. Epub 2007 Jun 12.
Yunnan is one of the poorest and most remote provinces in China. The reproductive health status of the population is poor. The aim of the study was to identify factors contributing to poor reproductive health and major barriers in accessing reproductive health information and care and to inform interventions to increase access to and the quality of care in service delivery.
The study was based on qualitative data collected from structured and unstructured interviews with health program managers, service providers, clients, and community members in three counties. Focus group discussions, field observations, reviews of the records of medical facilities and thematic analysis were used in the study.
Gender inequality and the fragmented health system were some of the barriers in accessing the services. Incorrect diagnosis, over treatment and IUD insertion with un-sterilised tools may have contributed to the persistent high rate of reproductive tract infections (RTI) in the study settings.
The improvement of reproductive health thus hinges critically upon the elevation of women's status. All health sectors within China's health system need to be better integrated and institutionally induced gender inequality ought to be reduced so that all in the population, particularly the vulnerable, will have equal and adequate access to reproductive health care.
云南是中国最贫困且最偏远的省份之一。当地人口的生殖健康状况较差。本研究的目的是确定导致生殖健康状况不佳的因素以及获取生殖健康信息和护理的主要障碍，并为增加服务提供中获得护理的机会和提高护理质量的干预措施提供依据。
本研究基于对三个县的卫生项目管理人员、服务提供者、服务对象和社区成员进行结构化和非结构化访谈所收集的定性数据。研究采用了焦点小组讨论、实地观察、医疗机构记录审查和主题分析。
性别不平等和碎片化的卫生系统是获取服务的一些障碍。诊断错误、过度治疗以及使用未消毒的工具进行宫内节育器插入操作可能导致了研究地区生殖 tract感染（RTI）持续的高发病率。
因此，生殖健康的改善关键取决于提高女性地位。中国卫生系统内的所有卫生部门需要更好地整合，并且应减少制度性导致的性别不平等，以便全体人口，特别是弱势群体，能够平等且充分地获得生殖健康护理。
