Perking Union Medical College Hospital, Chinese Academy of Medical Science& Perking Union Medical College, Beijing, China.
School of Public Health, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
BMJ Open. 2020 Jul 20;10(7):e034427. doi: 10.1136/bmjopen-2019-034427.
To analyse the trend change and level change of neonatal health services and neonatal mortality before and after the introduction of the Basic Public Health Service (BPHS) project in 2009.
A national longitudinal study on neonatal mortality from 1991 to 2017 and neonatal health services from 2000 to 2017 was conducted based on data extracted from the National Neonatal Mortality Surveillance System and National Health Statistic Yearbook. The segmented linear regression model was used to assess the level changes and trend changes of the outcome variables before and after the introduction of BPHS project. Pearson correlation analysis as conducted to measure association between neonatal mortality rates (NMRs) and maternal health management rates (MMRs), neonatal visit rates, respectively.
The outcome variables were national NMR, the gap of NMR between urban and rural areas, maternal health management rate and neonatal visit rate.
The annual trend change coefficient of national NMR and the gap of NMR between urban and rural areas were -0.57 (p<0.01) and -0.49 (p<0.01) after the introduction of BPHS project, while the annual trend coefficient of the MMR and the neonatal visit rate were 1.21 (p<0.01) and 0.85 (p<0.01), respectively. The negative correlations were found between NMR and MMR (r=-0.79, p<0.01) and neonatal visit rate (r=-0.76, p<0.01).
The BPHS project was found to be associated with increased volume of neonatal health services and reduced NMR. The design and implementation of this project may provide references to other low-income and middle-income countries.
分析 2009 年基本公共卫生服务项目（BPHS）实施前后新生儿健康服务和新生儿死亡率的趋势变化和水平变化。
基于国家新生儿死亡率监测系统和国家卫生统计年鉴中提取的数据，对 1991 年至 2017 年新生儿死亡率和 2000 年至 2017 年新生儿健康服务进行了全国性纵向研究。采用分段线性回归模型评估 BPHS 项目实施前后结局变量的水平变化和趋势变化。进行了 Pearson 相关分析，以衡量新生儿死亡率（NMR）与孕产妇健康管理率（MMR）、新生儿访视率之间的相关性。
结果变量为全国 NMR、城乡 NMR 差距、孕产妇健康管理率和新生儿访视率。
BPHS 项目实施后，全国 NMR 和城乡 NMR 差距的年趋势变化系数分别为-0.57（p<0.01）和-0.49（p<0.01），而 MMR 和新生儿访视率的年趋势系数分别为 1.21（p<0.01）和 0.85（p<0.01）。NMR 与 MMR（r=-0.79，p<0.01）和新生儿访视率（r=-0.76，p<0.01）呈负相关。
BPHS 项目与新生儿健康服务量的增加和 NMR 的降低有关。该项目的设计和实施可能为其他低收入和中等收入国家提供参考。
