中国宁夏四个县母婴保健服务干预措施的效果。

Effectiveness of an intervention on uptake of maternal care in four counties in Ningxia, China.

机构信息

Department of Child, Adolescent and Women's Health, Peking University, Beijing, China United Nations Children's Fund China Office, Beijing, China Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.

出版信息

Trop Med Int Health. 2012 Dec;17(12):1441-8. doi: 10.1111/j.1365-3156.2012.03092.x. Epub 2012 Sep 21.

DOI:10.1111/j.1365-3156.2012.03092.x

PMID:22994293

Abstract

OBJECTIVES

To understand the utilisation of prenatal care and hospitalised delivery among pregnant Muslim women in Ningxia, China, and to explore the effectiveness of the integrated interventions to reduce maternal mortality.

METHODS

Cross-sectional surveys before and after the intervention were carried out. Using multistage sampling, 1215 mothers of children <5 years old were recruited: 583 in the pre-intervention survey and 632 in the post-intervention study. Data on prenatal care and delivery were collected from face-to-face interviews. Maternal mortality ratio (MMR) data were obtained from the local Maternal and Child Mortality Report System.

RESULTS

After the intervention, the MMR significantly decreased (45.5 deaths per 100,000 live births to 32.7 deaths). Fewer children were born at home after the intervention than before the intervention (OR, 0.11; 95% CI, 0.08-0.15). The proportion of women who attended prenatal care at least once increased from 78.2% to 98.9% (OR, 24.55; 95% CI, 11.37-53.12). The proportion of women who had prenatal visit(s) in the first trimester of pregnancy increased from 35.1% to 82.6% (OR, 8.77; 95% CI, 6.58-11.69). The quality of prenatal care was greatly improved. Effects of the intervention on the utilisation of maternal care remained significant after adjusting for education level and household possessions.

CONCLUSIONS

The findings suggest that integrated strategies can effectively reduce maternal mortality.

摘要

目的

了解中国宁夏穆斯林孕妇产前保健和住院分娩的利用情况，并探讨降低孕产妇死亡率的综合干预措施的效果。

方法

在干预前后进行了横断面调查。采用多阶段抽样，共招募了 1215 名 5 岁以下儿童的母亲：干预前调查 583 人，干预后研究 632 人。通过面对面访谈收集产前保健和分娩数据。孕产妇死亡率数据来自当地母婴死亡报告系统。

结果

干预后，孕产妇死亡率显著下降（每 10 万活产儿死亡 45.5 人降至 32.7 人）。干预后在家分娩的儿童人数减少（OR，0.11；95%CI，0.08-0.15）。至少接受一次产前保健的妇女比例从 78.2%增加到 98.9%（OR，24.55；95%CI，11.37-53.12）。在妊娠早期接受产前检查的妇女比例从 35.1%增加到 82.6%（OR，8.77；95%CI，6.58-11.69）。产前保健质量得到了极大改善。在调整了教育水平和家庭财产后，干预对孕产妇保健利用的影响仍然显著。