Study On The Effectiveness Of Maternal And Child Health Of Qinba Health Program In Sichuan Province

Objectives: Evaluate and analyze influential factors of intervention effectiveness of Maternal and Child Health (MCH) of Qinba Health program in Sichuan province, moreover, summarize the beneficial experience and existing problems in this intervention of program, in order to provide reference on MCH program and work to a great extent from now on in program and non-program regions.Method: In Sichuan province, selecte non-program counties as contrast group, which is similar with program counties in nature, population, economy and state of MCH. Collect MCH data of each county and its relevant data between 1998-2005; in parts of program and non-program counties by the method of random layer sampling, select and carry a questionnaire on non-profit hospitals, the women who are pregnant currently or lying-in since 1998, simultaneously, partially make in-depth interview on the related personnel in program counties. Statistics description and single factor method is adopted to analyze the variational circumstance of intervention evaluation index in program counties, program and non-program non-profit hospitals, analyze the using circumstance of health service of pregnant and lying-in women, and their children, the gray correlative analysis of multi-attribute decision making with time series analytical method is applied on comprehensive evaluation to reflect total interfere result, on MCH work quality in program and non-program counties on 1998-2005 years; in the mean time, multiple regression is combined with path analysis method to analyse influence factors making use of the health service and health condition on women and children in poor region.Result: The program county is basic to attain the expected program target, besides percentage of hospitalized delivery, the variety circumstance of rest various index all is better than for the program not non-program non-profit hospitals. The impact factors analysis show from 1998 - 2005, program county MCH work quality seating arrangement is continuously raising, while there is undulate in non-program county; when the program carries out in front and back, the MCH work quality of program county exaltation degree is 2. 34 times than non-program county; in 2005, the investigation result of pregnant and lying-in women, and their children manifestate that pregnant and lying-in women of program region are higher than non-program region in registering on pregnancy hour, percentage of prenatal diagnosis, hospitalized delivery and new-method delivery, while common disease of children are lower in program region than in non-program region (P <0. 05). The outcomes of logistic regression show as follows, in poor region, influencing women making use of prenatal diagnosis are cultural degree, whether making use of care service before pre-pregnant, whether registering on pregnancy hour, pregnant and lying-in women whether knowing herself had set up health care system card for pregnant and lying-in women; the factors that impact women in poor region to use the hospitalized delivery service are habitation, whether program region, age, cultural degree, prenatal diagnosis times; the factors work on the post-natal visit service in poor region are habitation, lying-in women whether knowing herself had established system management card for pregnant and lying-in women, prenatal diagnosis times; the factors that influence children in poor region to make use of children health care serve have already listed, whether registering on pregnancy hour, prenatal diagnosis times. The outcomes of path analysis display that the factors impacting maternal and child mortality rate in poor county are general fertility rate, proportion of agriculture population, per capital annual net income of rural household, MCH program numbers, per capital MCH expenditure, average mumber of MCH personnel of village, average mumber of assist women in childbirth of village, percentage of hospitalized delivery, pregnant and lying-in women system management rate, whether carrying on evaluation of maternal and child mortality, whether establishing, assess system to MCH personnel of non-profit hospitals, monitoring and guiding MCH work of village by county, percentage of high-risk pregnancy women, maternal mortality rate is also one of the influence factors of child mortality rate in the meantime, the direct effect of which is0. 082.Conclusion: The MCH intervention of program, which has been carried out 8 years, obtains better result and commulates some experiences. But also exists some shortage, further more, many factors influence intervention effectiveness of MCH program in poor region. Aim at above circumstances, for further implementing MCH program and carrying MCH work on, suggest as follows: (1) MCH program should be inclined to the poor region of westward department, the point is rural; (2) All levels leadership in the program region should value the progranm and insure the program fund put into effect; (3) Strengthen constructing MCH care section in non-profit hospitals to improve the service ability of MCH; (4) Continue to push forward the training of MCH personnel and optimize training mode; (5) Promise MCH personnel's quantity in village, pay attention to the working talent change of assist women in childbirth of village; (6) Value pre-pregnant and post-natal visit care, overall implementing MCH work; (7) Strengthen health education, raise the consciousness of women and children; (8) Strengthen Medicaid work to increase ability of making use of MCH; (9) Strengthen monitoring and guiding, promise MCH program work carrieied out smoothly.