Harris Amanda, Gao Yu, Barclay Lesley, Belton Suzanne, Yue Zweng Wei, Min Hao, Auqun Xu, Hua Liao, Yun Zhou
Graduate School for Health Practice, Institute for Advanced Studies, Charles Darwin University, Darwin, Australia.
Reprod Health Matters. 2007 Nov;15(30):114-24. doi: 10.1016/S0968-8080(07)30315-7.
This paper comments on the provision of birthing services in Sichuan and Shanxi Provinces in China within a policy context. The goal was to understand possible unintended and harmful health outcomes for women in the light of international evidence, to better inform practice and policy development. Data were collected from October 2005 to April 2007 in 25 hospitals across 13 counties and one city. Normal and caesarean birth records were audited, observations made of facilities and interviews conducted with officials, administrators, health workers, women who delivered in hospital facilities and women who delivered at home. We argue that in the context of a neo-liberal health economy with poorly developed government regulatory policies, those with the power to pay for maternity care may be vulnerable to a new range of risks to their health from those positioned to make a profit. While poor communities may lack access to basic services, wealthier socio-economic groups may risk an increase in maternal morbidity and mortality through the overuse of avoidable intervention. We recommend a stronger evidence base for hospital maternity services and changes to the role of the State in countering systemic problems.
本文在政策背景下对中国四川省和山西省的分娩服务提供情况进行了评论。目标是根据国际证据了解对女性可能产生的意外和有害健康结果，以便更好地为实践和政策制定提供信息。2005年10月至2007年4月期间，在13个县和1个市的25家医院收集了数据。对顺产和剖宫产记录进行了审核，对设施进行了观察，并与官员、管理人员、医护人员、在医院分娩的妇女以及在家分娩的妇女进行了访谈。我们认为，在政府监管政策不完善的新自由主义卫生经济背景下，那些有能力支付产科护理费用的人可能容易受到那些以盈利为目的的人带来的一系列新的健康风险。虽然贫困社区可能无法获得基本服务，但较富裕的社会经济群体可能因过度使用可避免的干预措施而面临孕产妇发病率和死亡率上升的风险。我们建议为医院产科服务建立更坚实的证据基础，并改变国家在应对系统性问题方面的作用。
