Difficulties And Strategies Of Premarital Health Check-up Policy In Shanghai

As a medical examination for couples before marriage,premarital health check-up which is one of the most widely used policy can discover serious inherited diseases,some infectious diseases and relevant mental disorder,and it has played an important role in improving the quality of our newborn babies.Three periods of premarital health check-up have been experienced in China since the policy was implemented in 1986 including compulsory period,voluntary period and free voluntary period.Recently,China further relaxed its more than three-decade-old family planning policy to the universal two-child policy,thus better childbearing and rearing has become a more realistic policy demands.Since 2004 we have been faced with the continuous decent situation of premarital examination rate,the gradual ascent situation of birth defect rate and controversial comments on premarital health check-up therefore it is of great interest to do the research on difficulties and strategies of this policy.Shanghai,one of first-tier megalopolis with high population density,advanced economy and abundant public health service resources,has been chosen for the representative in this paper.We empirically studied on implementation status of a typical central area in Shanghai,District A,by using documents consultation,questionnaire survey and structural interview.On the basis of statistical consequences about couples’ cognition and identification degree to the policy as well as the influence factors correlated with the behavior of premarital check-up,public goods theory and public choice theory have been employed to analyze the causes of existing issues encountered in policy design and execution.Furthermore,governments abroad have accumulated abundant experience in the practice of premarital screening,which provide some inspirations and references to our policy optimization.Finally,in the view of public administration the paper put forwards the countermeasures as follows: first of all,premarital health check-up items should be simplified — cancelling inspection of routine physical and testimony of mental illness,screening infectious diseases such as HIV and STD compulsively,enhancing counselling service and health promotion for people of reproductive age.Secondly,laws and regulations should be amended to perfect our policy system.After substantive review of premarital health check-up would have been substituted by formal review,relevant remedy clauses should be specified to protect the innocent party in marriage relationship.Thirdly,a new mode of women health care should be established to provide full-process medical service before marriage,pregnancy,reproduction,menstruation and menopause by breaking the monopoly in premarital medical service field,connecting with electronic health records of residents and standardizing physician qualification management and professional behavior,which corresponds to the age of universal two-child policy.Last but not the least,it is essential to gain a social consensus of premarital health check-up which could promote public’s sense of self-preservation as well as social responsibility.In order to achieve the consensus above in a long term sight,our government and mass media need to develop publicity activities and propaganda according to different target groups such as newlyweds,college graduates and adolescent students.