Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China.
Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China.
Int J Environ Res Public Health. 2021 Apr 17;18(8):4261. doi: 10.3390/ijerph18084261.
This study aimed to analyze the changes in the 10 major categories of women's healthcare services (WHSs) in Shanghai (SH) and New York City (NYC) from 1978 to 2017, and examine the relationship between these changes and maternal mortality ratio (MMR). Content analysis of available public policy documents concerning women's health was conducted. Two indicators were designed to represent the delivery of WHSs: The essential women's healthcare service coverage rate (ESCR) and the assessable essential healthcare service coverage rate (AESCR). Spearman correlation was used to analyze the relationship between the two indicators and MMR. In SH, the ESCR increased from 10% to 90%, AESCR increased from 0% to 90%, and MMR decreased from 24.0/100,000 to 1.01/100,000. In NYC, the ESCR increased from 0% to 80%, the AESCR increased from 0% to 60%, and the MMR decreased from 24.7/100,000 to 21.4/100,000. The MMR significantly decreased as both indicators increased ( < 0.01). Major advances have been made in women's healthcare in both cities, with SH having a better improvement effect. A common shortcoming for both was the lack of menopausal health service provision. The promotion of women's health still needs to receive continuous attention from governments of SH and NYC. The experiences of the two cities showed that placing WHSs among policy priorities is effective in improving service status.
本研究旨在分析 1978 年至 2017 年间上海（SH）和纽约市（NYC）的 10 大妇女保健服务（WHS）类别的变化，并探讨这些变化与孕产妇死亡率（MMR）之间的关系。对现有的妇女健康公共政策文件进行内容分析。设计了两个指标来代表 WHS 的提供情况：基本妇女保健服务覆盖率（ESCR）和可评估的基本保健服务覆盖率（AESCR）。使用 Spearman 相关分析来分析这两个指标与 MMR 之间的关系。在 SH，ESCR 从 10%增加到 90%，AESCR 从 0%增加到 90%，MMR 从 24.0/100,000 下降到 1.01/100,000。在 NYC，ESCR 从 0%增加到 80%，AESCR 从 0%增加到 60%，MMR 从 24.7/100,000 下降到 21.4/100,000。随着两个指标的增加，MMR 显著下降（<0.01）。两个城市的妇女保健都取得了重大进展，SH 的改善效果更好。两个城市的共同缺点是缺乏更年期保健服务。促进妇女健康仍需要 SH 和 NYC 政府的持续关注。两个城市的经验表明，将 WHS 置于政策优先事项中，对于改善服务状况是有效的。
