| Objectives: To analyze the distribution and development of maternal and child health resources in Baiyin from 2006 to 2018,the development and differences of maternal and child health services in Baiyin from 2006 to 2018,and the dynamic and static efficiency of maternal and child health services.Based on the results of internal data analysis,and the comparison of provincial and national levels and related planning goals,comprehensively evaluate the development of maternal and child health services in Baiyin from 2006 to 2018,and identify the weak parts of maternal and child health work.Then provide suggestions for optimizing the allocation of maternal and child health resources,improving the capacity and efficiency of maternal and child health services,and ultimately promote the maternal and child health in Baiyin City.Methods: Descriptive analysis was used to evaluate the distributions and trends of maternal and child health resources.The relative ratio with fixed base,chain relative ratio,trend test of Chi-square,and Joinpoint regression were adopted to analysis the development trend of relevant indicators for women and children's health services in Baiyin from 2006 to 2018.Entropy Coefficient Method was applied to compare the work of maternal and child health in each county.Data envelopment analysis was used to assess the static efficiency of maternal and child health services in counties of Baiyin in 2018,and the change of total factor production efficiency from 2014-2018 were calculated by Malmquist Index.Results:(1)The maternal and child health resources in Baiyin were on an upward trend from 2006 to 2018.From the perspective of maternal and child health workers,the total increase was 58.20% from 2006 to 2018,of which nurses increased the most,and doctors showed a slow growth trend.From the perspective of maternal and child health beds,the total number of beds increased by 57.29% from 2006 to 2018,with the most obvious increase in the number of pediatric beds and obstetric beds.From the perspective of maternal and child health care projects,the total number of projects increased by 23.08% from 2006 to 2018.The number of projects in women's health care and children's health care accounted for the largest proportion,but the growth change was not obvious,and the number of consulting outpatient projects increased apparently.In 2018,the number of maternal and child health staff and beds in each county were unevenly distributed.The per capita maternal and child health resources in Baiyin and Pingchuan were at a higher level of the whole city,followed by Jingtai and Huining,Jingyuan was at the lowest level.(2)From the maternal health indicators,the maternal card establishment rate,maternal checkup rate,postpartum visit rate,maternal system management rate,and hospital delivery rate all increased from 2006 to 2018.The prevalence of maternal moderate to severe anemia was declining,and maternal mortality was fluctuating from 2006 to 2018.From the health service indicators of children under seven,the underfive mortality rate,neonatal mortality rate,infant mortality rate,the incidence of low body weight and moderate to severe anemia in children under five have all steadily decreased from 2006 to 2018.The neonatal visit rate,neonatal disease screening rate,system management rate for children under three,and health care coverage for children under seven have all shown an upward trend from 2006 to 2018.The breastfeeding rate within 6 months presented a fluctuating trend from 2006 to 2018.From the screening and prevalence of gynecological disease,the screening rate continuously increased,and the overall prevalence of gynecological disease showed irregular fluctuations from 2006 to 2018.(3)From 2006 to 2018,the scores of maternal health services and children's health services indicted continuously rising trends,the scores of gynecological disease screening work showed fluctuating rising trend,and the differences in maternal and child health work scores among counties were continuously diminishing.The maternal and child health work scores in each region were closely related to the economic development level and maternal and child health service capacity of each region.(4)From the static results of Data Envelope Analysis,the efficiency of maternal and child health services in Baiyin District and Jingyuan County was relatively effective;Jingtai County was at weak efficiency and showed increasing returns to scale;the invalid status of Pingchuan District is caused by the low technical level and small scale;the invalid state of Huining County is caused by the low technical level and large scale.From the dynamic results of the Malmquist index,the total factor productivity efficiency of women and children's health services in Baiyin City from 2014 to 2018 demonstrated a fluctuated change,and its efficiency changes were mainly affected by scale efficiency change.From 2014 to 2018,the total factor production efficiency of maternal and child health services in of Baiyin District and pingchuan District showed an upward trend,and itsmean values of total factor productivity efficiency were 1.052 and 1.034;Jingyuan County,Huining County and Jingtai County presented a downward trend,and its mean values of total factor productivity efficiency were 0.984,0.867 and 0.869.Conclusions:(1)The maternal and child health resources in Baiyin were on an upward trend from 2006 to 2018.In 2018,the number of maternal and child health workers and the number of beds in all counties of Baiyin City were unevenly distributed.(2)From 2006 to 2018,the maternal and child health services in Baiyin City proceed orderly.The maternal and child work indicators were generally presented rising trends,and the health and death indicators were showed downward trends.In 2018,the maternal mortality rate,under-five mortality rate,and infant mortality rate in Baiyin City have reached the goals of the “Healthy China 2030 Plan Outline”.(3)From 2006 to 2018,the comprehensive evaluations of maternal and child health services in all counties(districts)of Baiyin City showed an upward trend,and the differences among regions were continuously diminishing.(4)In 2018,there were differences in the efficiency of maternal and child health services among counties(districts)in Baiyin City.The total factor productivity efficiency of women and children's health services in Baiyin City from 2014 to 2018 demonstrated a fluctuated change,and its efficiency changes were mainly affected by scale efficiency change.From 2014 to 2018,the total factor production efficiency of maternal and child health services in of Baiyin District and pingchuan District showed an upward trend,while Jingyuan County,Huining County and Jingtai County presented a downward trend. |
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