Influencing Study Of Ncms On Rural Pregnant Women Health Care In Rongchang

Objective: To Understand NCMS statusquo for the pregnant woman health care in Rongchang County, and to analyze NCMS influence to the service use and expenditure of prenatal visit and childbirth in hospital, to the service content and the organization development of hygienic servic supplier, to sum up experiences, to find problems, and to propose the rationalization proposal. To provide the basis for improving the maternal infant health care policy to the policy maker and health service manager.Method: (1) Method of information acquisition: adopt the quantitative methods and qualitative methods. In the quantitative investigation, 250 Rongchang rural women delivered in April 2008 to December were selected based on stratified cluster sampling. Four aspects were investigated by questionaire, which including general family information, history of pregnant and delivery and pregnant care, intrapartum care, and postpartum visits. This research understood emphatically NCMS attending situation, awareness, whether to obtain reimburses, reimburses project, the expense and so on. On the other hand, collection policy related data in County health bureau, county maternal and child care service centre, county NCMS office. In The qualitative investigation, the key interviews, hygienic service provider as well as the user were selected to carry on the key man interview, the focus group discussion and In-depth interview based on purposive sampling method. (2) Information analysis method: use the Epidata software to construct database to carry on the double input and use the SAS 8.2 software to analysis the quantitation data; use the MAXqda2 software management qualitative data and uses the subject frame analytic method to analysis the qualitative data.Results: (1) The knowing rate of NCMS policy is low. 39.25% women who participate in NCMS thought that the prenatal visit may reimburse and 69.89% women thought that childbirth in hospital may reimburse. The town and village publicity education network function is being out of balance, and the health education propaganda work isn't well. (2) NCMS to prenatal visit's subsidy 100 Yuan, compensation median is 60 Yuan actually. The prenatal visit subsidy project times and amount in NCMS is limited, its function is not big to pregnant woman whether to elect the subsidy project inspection besides there is a slight stimulation to ultrasound that spend relatively high. (3) The childbirth in hospital expenditure median is 2000 Yuan. After in 2007 NCMS policy adjustment, the fixed childbirth reimburse in hospital is 400 Yuan. The influence to choose the childbirth place and the childbirth way is not big to the women who obtained or didn't obtain reimbursement in the identical age group, the same year per-capita income group, the identical cultural group. Compared with the proportion reimbursement policy before 2007 which according to the hospital rank, the fixed point hospital and fixed reimbursement, had certain inhibitory action to the excessively quickly c-section rate, caused the woman whose current economic condition is common more went to childbirth in towns Public health center, enhance further medical personnel vocational level and ability in the town health centers, increased the basic hospital income. (3) Because NCMS reimbursement to childbirth is limited, the economic burden of underprivileged parturient that spent much money is heavy as before. (4) Because the NCMS overall plan level is low, The NCMS reimbursement procedure of transient woman is relatively complex. (5) There is no reimbursement in NCMS, and the parturient that doesn't conform to the family planning policy is still the maternity and child care difficulty.Conclusion: After NCMS policy adjustment in 2007, the prenatal visit and childbirth in hospital have been included, and the women have been given fixed reimbursement. It is advantageous in enhancing the pregnant woman hygienic service using rate and the development of the basic health Medical establishment partly, but there are many problems which need to further improve. We should enhance the public education awareness and practical ability of villages doctors and township hospital staff unceasingly to improve the work effect; Enhances moderately the pregnant woman health care subsidy amount in NCMS, and sets particular population reimburses; Enhances the NCMS overall plan level, reduces transient population reimbursement procedure, and strives for to realize"a card to take the world"; Continues to display function of NCMS and explore the new way positively to suppress the high c-section rate.