| Background and Objective:Researches in recent years indicate that with the rapid development of economy and changes of people's lifestyle,children's physical development improves gradually and the health status shows a new model.The prevalence of malnutrition and anemia diminish.But the rate of overweight/obesity and poor eyesight increase yearly,and the incidence of dental caries is still at a high level.All these changes bring new challenges and requirements for child health care work in kindergardens.This study aims to investigate the status of children's growth and health in Gulou District of Nanjing,and to find out the problems in health care,so as to provide suggestions and theoretical basis for institutions to optimize and perfect the health care of kindergardens and constantly improve the management level of health care and health level of children in kindergardens.Methods:10676 health physical examination forms of children aged 3-6 years old from 40 kindergardens in Gulou District in 2014 were collected.The common diseases affecting children's growth and health(malnutrition,overweight/obesity,dental caries,anemia,poor eyesight,etc.)are analyzed one by one.Moreover,The annual statement of health care in Nanjing municipal kindergardens and The performance report of health care system in Nanjing municipal kindergardens from 2004 to 2015 were also collected from maternity and child care institutions to explore the dynamic trend of local children's health status and health care working condition in these twelve years.The comprehensive assessment of children's health status in Gulou District is conducive to find out problems of the health care management and intervention measures for promoting the health care management level and children's health status.After check of all data entry Excel and Epidata 3.1 table,statistical analyses are performed using SPSS 19.0.Numerical variable data used t-test and analysis of variance;Categorical variable data used chi-square test and rank sum test;Trends of children's health status used linear trend chi-square test.Results:1.The qualification rate of health care in kindergardens of Gulou District from 2004 to 2015 shows a overall upward trend,rising to 100%in 2014;The ratio of professional health workers,personnel owning technical secondary school degrees or above and nursing staff to doctors present a upward trend respectively;The ratio between health care workers and children ranges from 1:193 to 1:225.The prevalence rate of infectious diseases is 1.65%on average and the average growth rate is 8.1%.2.The rate of height up to the average standard among kids aged 3-6 years old is 81.05%,weight is 79.67%in kindergardens of Gulou District.From 2004 to 2015,the two rates show a upward trend(P<0.01).The average height and weight of boys and girls exceed the standard of WHO and access the level of other nine cities and Nanjing;The overall mean value of BMI is 16.34± 1.94.BMI values at all ages of boys and girls exceed the standard of WHO and other nine cities,and the difference is statistically significant(P<0.01).The prevalence rate of obesity is 8.62%.The major type of obesity among kids is the mild one.The detection rate of overweight is 18.86%.The incidence of obesity assumes the up tendency yearly(P<0.01);The incidence of malnutrition is 7.10%.Emaciation accounts for the main proportion of malnutrition.The detection prevalence rates of malnutrition appear a downward trend(P<0.01)from 2004 to 2015;The average hemoglobin is 127.85±9.00 g/1.The detection prevalence rate of anemia of these kids is 0.18%.The incidence of obesity among children with anemia is higher than that of kids with no anemia obviously(P<0.01),and so is malnutrition and caries.The detection prevalence rates of anemia appear a downward trend(P<0.01)from 2004 to 2015;The prevalence rate of dental caries is 30.12%,and these kids have 1.03 caries on average.In addition,the prevalence of malnutrition among children with caries is higher than that of kids with no caries(P<0.05).Children with caries also have lower prevalence rates of height and weight up to the average than those without caries(P<0.01).With the age advancing,the incidence of caries advances,but has a decreasing trend(P<0.01)from 2004 to 2015;The rate of abnormal vision is 13.98%.The major type of ametropia is astigmatism,followed by hyperopia among these children.The incidence of obesity among children with poor eyesight is higher than that of kids with good vision(P<0.05),From 2004 to 2015,the detection rates of vision less than 4.8 are on the rise(P<0.01).Conclusions:1.The overall level of health care is good,the qualified rate of health care,the filing rate of child health and the physical examination rate of 61 are relatively high.But health care personnels in this study have not been Matched standards required by Ministry of Health and Ministry of Education in Management and the level of health care in different kindergardens is not balanced.so,it needs to modify the model of health care personnel,improve their quality and awareness,guide work classifily in kindergardens and focus on strengthening supervision especially in qualified kindergartens.2.The level of children's physical growth in Gulou District is also good,over the standard of WHO and close to the standard in other nine cities.The incidence of obesity and poor eyesight increase yearly,but the prevalence of anemia,caries and malnutrition decrease,which is still lower than the national average level.Therefore,further health care work needs to be focused on prevention and intervention of obesity and poor vision.Besides,malnutrition,anemia and caries can not be ignored.Enhancing communication and creating a new model of trinity including maternal and child health care institutions,kindergardens,families also need to be done to improve the level of children's health in kindergardens continuously. |
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