Investigation On The Status Quo Of Maternal And Children Health Service In Rural Tertiary Medical Institutions In Minority Areas Of Western China

Objectives:To understand the situation of staffing,basic equipment and articles,service carried out,water and sanitation environment in maternal and child health care institutions in the minority areas of western China,analyzing their current status and predicament,and toapply realistic basis that improve the service of the maternal and child health care institutions in impoverished minority areas of western China.And promoting the healthof women and children in the surveyed area.Ensuring that they can enjoy complete maternal and child health care services,and promoting the continuous improvement of maternal and child health care service institutions that at different levels.Methods:Using a self-administered questionnaire that was designed by the expert group from Peking University and sampled by proportional probability of capacity(pps).Six county-level maternal and child healthservice institutions,thirty-two township health centers and sixty village clinicsin Shigatse,Tibet Autonomous Region and Liangshan Yi Autonomous Prefecture in Sichuan Province were recruited,where health technicians,equipment and articles for maternal and child services,content of basic maternal and child care services,water and sanitation environment were investigated.Results:1.Basic situation: The ethnic composition of two counties in Tibet is dominated by Tibetans(over 95%),and the ethnic composition of two counties in Sichuan is dominated by the yi nationality(more than 65%),and mountainous is the main terrain.The two counties in Tibet are extensive land with sparse population and have an altitude of more than4,400 meters above sea level.The population in Sichuan is relatively concentrated and the elevation is low.The average capita income in the surveyed areas was lower than the average of 11,142 yuan of rural residents in China.2.Health technical personnel: The county-level maternal and child health care service institutions have 561 health technical personnels,accounting for 53.88% of college graduates,and there has no postgraduate education technicians.The average in Tibet is 30.5,and the average in Sichuan is 131.75.The township health center have 353 health technical personnels,with a college degree of 58.92%,and an average of7.8 people in each township hospital in Tibet,and 12.45 in Sichuan.3.Maternal and child equipment facilities: For the county-level maternal and child health care service,the overall allocation rate of prenatal care items was 88.74%,the overall allocation rate of production and delivery items was 81.57%,and the overall allocation rate of children's outpatient health care products and medicines was 58.33%.For the township health center,the overall allocation rate of prenatal care items was 62.5%,the overall allocation rate of production and delivery items was 16.94%,the overall allocation rate of children's outpatient health care products and medicines was 42.19%.and for the village clinic,the overall allocation rate of maternal and child care equipment was41.25%.4.Maternal and child health care services: For the county-level maternal and child health care services institutions,the developed rate of maternal and child care services was 51.67%,of which the rate of delivery service,postnatal visits,and vaccination initiation were all 100%.For township health centers,the highest rate for maternal and child health care services is postnatal care visit service(87.50%).The lowest rate was15.63% for children's psychological and behavioral development counseling services.Other basic maternal and child health care services were also generally lower than 60%.For village clinics,the highest rate was 66.67% for mobilizing pregnant women to delivery in hospital,andthe lowest rate was 11.67% for births.5.Water and environmental sanitation: For county-level maternal and child health care institutions,all of which are centralized water supply,water-saving and convenient toilets.All of them have washbasins,and the main locations are in the toilet or doorway,in the ward,in the delivery room,in the operating room,and in the office.For township health centers,thereare eight institutions that use tap water for centralized drinking water,accounting for 25% of the total,of which clean toilets(sanitary toilets and flush toilets)are 87.5%,and 23 institutions have set up washbasins,which located in offices and clinics.For village clinic,the source of drinking water for thirteen village clinics is concentrated tap water,accounting for 21.67% of the total,and the proportion of sanitary toilets is 73.33%.There are no washbasins in the forty-four village clinics.Conclusion:The overall service capacity of different levels of maternal and child health service institutions in the surveyed areas is insufficient.The number of health technicians is small and the level is not high.Grass-roots units are particularly lacking full-time maternal and child health care personnel and lacking training and learning.The equipment items that can be used for maternal and child health care are grossly inadequate,especially in the village clinics.For the maternal and childhealth services,the county-level institutions as a whole are superior to the township health centers and village clinics,but it's child care services are inadequate.Township health centers and village clinics are poor in terms of water and sanitation condition.