Ma Yi, Bai Fu, Gao Lina, Fan Yanjun
Department of ART Management, National Centre for Women's and Children's Health, Beijing, China.
Hum Fertil (Camb). 2023 Jul;26(3):573-581. doi: 10.1080/14647273.2021.1969043. Epub 2021 Aug 19.
Infertility is a global health problem that carries a high social and economic burden. Assisted reproductive technology (ART) has been developed in mainland China for over 30 years. We aimed to evaluate the accessibility and equity of distribution of ART facilities in mainland China from 2006 to 2018 and quantify the population with reduced geographic access to ART services. A retrospective study was conducted to describe the trend and analyse the equity of distribution of ART clinics in 2006, 2012, and 2018. The accessibility of ART clinics in mainland China increased significantly in the 12 years to 2018 ( ˂ 0.05). Eastern China had the most extensive coverage, followed by the central region, while the western region had the least coverage ( ˂ 0.05). The Gini coefficient for the distribution of ART clinics in 2018 was 0.213, indicating that the equity of distribution of ART clinics was relatively balanced over the country. However, at the end of 2018, there were still 354.9 million people (25.4% of the population) living in 148 cities without access to any ART clinics, which has spurred more targeted policies and cost-effective measures to improve the accessibility and availability of ART services in such areas.
不孕症是一个全球性的健康问题，带来了沉重的社会和经济负担。中国大陆开展辅助生殖技术（ART）已有30多年。我们旨在评估2006年至2018年中国大陆ART机构分布的可及性和公平性，并量化地理上难以获得ART服务的人群数量。进行了一项回顾性研究，以描述趋势并分析2006年、2012年和2018年ART诊所分布的公平性。到2018年的12年里，中国大陆ART诊所的可及性显著提高（<0.05）。华东地区覆盖范围最广，其次是中部地区，而西部地区覆盖范围最小（<0.05）。2018年ART诊所分布的基尼系数为0.213，表明全国ART诊所分布的公平性相对均衡。然而，截至2018年底，仍有3.549亿人（占总人口的25.4%）生活在148个没有任何ART诊所的城市，这促使出台更具针对性的政策和成本效益高的措施，以改善这些地区ART服务的可及性和可得性。
