Shen Yuan, Li Qiang, Liu Xiaoning, Xiao Shengbin, Yan Hong
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi.
Department of Epidemiology and Health Statistics, School of Public Health, LanZhou University, Lanzhou, Gansu, China.
Medicine (Baltimore). 2019 Nov;98(45):e17709. doi: 10.1097/MD.0000000000017709.
The rising maternal and child healthcare costs and the lack of training and educational resources for healthcare workers have reduced service quality in primary health centers of China. We sought to compare strategies promoting healthcare service utilization in rural western China.
A randomized community trial was carried out in Zhen'an country between 2007 and 2009. Two cross-sectional surveys were conducted to compare the outcomes of financial subsidy for pregnant women seeking antenatal care and clinical training provided to healthcare workers by difference-in-difference estimation.
In all, 1113 women completed the questionnaires. The proportion of postnatal visits increased three times in the training group, reaching 35.7%. The number of women who received advice from their doctors regarding nutrition and warning signs necessitating immediate medical attention also improved significantly (5.8% and 8.2%, respectively). Furthermore, the percentage of women who underwent blood tests increased significantly to 19.5% in the training group. Compared to the financial group, the training group had more women who breastfed for longer than 4 months (15.8%) and provided timely complementary feeding (8.9%).
The training intervention appeared to have improved prenatal care utilization. Essential obstetric training helped enhance knowledge and self-efficacy among healthcare workers.
孕产妇和儿童医疗保健成本的上升以及医护人员培训和教育资源的匮乏，降低了中国基层医疗中心的服务质量。我们试图比较促进中国西部农村地区医疗服务利用的策略。
2007年至2009年期间在镇安县开展了一项随机社区试验。进行了两项横断面调查，通过差分估计比较为寻求产前护理的孕妇提供财政补贴以及为医护人员提供临床培训的效果。
共有1113名女性完成了问卷调查。培训组产后访视的比例增加了两倍，达到35.7%。接受医生关于营养和需要立即就医的警示标志建议的女性人数也显著增加（分别为5.8%和8.2%）。此外，培训组接受血液检查的女性比例显著增加至19.5%。与财政补贴组相比，培训组中母乳喂养超过4个月（15.8%）和及时提供辅食（8.9%）的女性更多。
培训干预似乎提高了产前护理利用率。基本产科培训有助于提高医护人员的知识水平和自我效能感。
