A Study On The Comprehensive Evaluation Of Rural Maternal And Child Health Service System

Objective:To understand the input, resource allocate and utilization efficiency of maternal and child health resources in project provinces, provide the basis for rational allocate the maternal and child health resources, and improve the resources utilization efficiency, and formulate the development plan of regional maternal and child health.Methods:According to the main function of the maternal and child health service system, it was divided into county, township, village, three-level of maternal and child health service evaluation system. Based on an extensive literature review, using the Delphi method and Entropy method to establish a comprehensive evaluation index system and utilizing the weighted rank method to establish the comprehensive evaluation model of maternal and child health services in rural areas. Calculated the comprehensive strength and function scale effective U-of maternal and child health services.Taked advantage of barber-johnson schematic to analyze the input-output efficiency of maternal and child health service in China’s rural areas.Results:The input of rural maternal and child health included allocation of health resources, while the output included the utilization and demand for maternal and child health service, and the status of maternal and child health. According to "The research report of China sub-regional comprehensive economic strength", divided the eight project provinces into four regions. Used the RSR method to evaluate the human resources, material resources, financial resources and operating situation, investment size and output functions of8project provinces comprehensively, we could find that within the investment scale of maternal and child health service system in rural areas, there were irrational resources allocation, unbalance of resources inputs and so on. Located in the province of C of one class in rural areas, the material resources, financial resources and operations were located in third and second place, respectively, while the human resources was in the last place. The input of human resources of province B was in the first place, on the contrary, the material resources was in the six. The study on comprehensive strength of maternal and child health service system showed that the model of overall strength evaluation was:(?)WRSRcomprehensive=0.7135×(?)AWRSRinvestment+0.2865×(?)WRSR output.The evaluation of comprehensive strength was showed that the province B and E which were located in the second place were stronger than the province of G and H which were in the third and fourth place.The results of the function scale effective U of maternal and child health service system showed that the8project provinces functional effectiveness (U) were all less than1. It indicated that the resources investment was higher in the project provinces of maternal and child health resources, but the output was lower, and the utilization ratio of health resources was also low. The investment scale were respectively in second and third place of E and D provinces, while the output functions were located in seven and six place, indicated that the phenomena of wasted of maternal and child health service resource, and lower utilization of health services were still exist. The research results of barber-johnson schematic analysis showed that there were only11project counties had the high-input and high-output,which accounted for27.5%in40project counties in eight project provinces, and most of them were distributed in more economically developed such as second and third regions in which the B and F province had a high proportion, accounted for75%and40%respectively. There were nine project counties had the low-input and low-output, accounted for22.5%, which was because of lower maternal and child health resources input and located in the fourth regions which economic was undeveloped. The proportion of low-input and low-output counties in G project province were accounted for60%; There were nine project counties had high-input and low-output, which accounted for22.5%, it reflected that the services efficiency of maternal and child health were decreased.Conclusions:There were generally phenomenon of irrational allocation of resources and low efficiency of maternal and child health services in China rural maternal and child health service system. Especially in the three and four types of rural areas, the input of health resources were insufficiency, and the comprehensive strength were weak. Suggested that the government should strengthen their responsibility, increase the governmental investment, strengthen the planning of maternal and child health human resources, optimize the allocation of human resources, improve the management modes and change the management concept, to increase the effective utilization of maternal and child health services.