Study On The Present Situation Of Child Health Care Service And Maternal And Child Health Literacy In Guiyang Primary Health Institutions

Objective:To understand the current situation of primary-level child health care services in Guiyang from the perspectives of supply and demand,analyze the existing problems,and on this basis,understand the maternal and infant health literacy level of primary-level rural pregnant women in Guiyang,and analyze the current situation and related needs of maternal and infant health knowledge.To explore its influencing factors,to provide reference for further developing health education and improving the capacity of primary-level children’s health care services.Methods:In the first stage,combined with quantitative and qualitative analysis,multi-stage stratified cluster random sampling was used to investigate the child care service situation of 40 grass-roots health institutions in Guiyang City and some child care persons in charge and child care personnel in 2020.One parent of a child conduct a needs survey and interviews the person in charge of child insurance.In the second stage,the method of stratified cluster random sampling is used to conduct a questionnaire survey of pregnant and lying-in women receiving health management in grass-roots rural areas in 2021 to analyze the influencing factors of maternal and child health literacy of pregnant and lying-in women.Epi Data3.1 software was used to input and sort out the data,and SPSS24.0 software was used for statistical description,and SWOT was used to summarize the interview results.The utilization rate and composition ratio of classified data were statistically described,the comparison of counting data was tested,and the quantitative data were in line with normal distribution((?)±s).Multiple factors analysis using the binary classification unconditional Logistic regression model.Level α=0.05 was tested.Results:Provision of basic health facilities: 50%(10/20)of outpatient rooms in community health service centers failed to meet the standard,and 15%(3/20)of rooms in township health centers did not meet the standard;primary health institutions were equipped with basic child care service equipment,and community 55%(22/40)and 25%(10/40)are equipped with children’s sphygmomanometers and children’s health education equipment in townships and villages respectively.The psychological behavior assessment and examination were not equipped with corresponding examination equipment.Child care services in primary health institutions: The rates of neonatal visits,health management for children under 3 years old and children under 7 years old were 97.03%,91.48% and 92.14%,respectively.In general,87.5%(35/40)of primary health institutions completed the management rate of the National Action Plan for Healthy Children,and 72.5%(29/40)of the action Plan for Healthy Children in Guizhou Province.The visiting rate of newborns in township health centers was 2.6 percentage points higher than that in community health service centers(χ2=80.989,P=0.001).The prevalence of nutritional diseases in children under 5 years old is 4.67%,0.08%,0.67%,4.56% and 1.10%,all lower than the national regulation control index.The human resources of child care: 69.44%(75/108)of the child care personnel have junior college degree or below,and 49.07%(53/108)have not received professional title.76.85%(83/108)of the staff had a basic knowledge of basic child care.The overall satisfaction of parents with the basic child care services was 83.37%.The interview results show that the penetration rate of basic child care services is high,and there are problems such as the instability of the basic child care team and the inability of the basic child care services to meet the needs of children and parents.Maternal and infant health literacy in rural areas: The maternal and infant health literacy literacy rate was 29.08%(267/918),and the basic knowledge and concept literacy rate was the lowest(28.10%).Maternal overall health literacy rate was higher than that of pregnant women,the difference was statistically significant(χ2=15.408,P<0.05).The results of univariate analysis of maternal and infant health literacy were as follows: The higher the education level and the per capita monthly income of the family,the higher the maternal and infant health literacy level(P<0.05).Maternal and infant health literacy of women who used maternal and infant health manual and paid more attention to health education was higher than that of women who did not use maternal and infant health manual and paid less attention to health education(χ2=35.323,P<0.05,χ2=20.812,P<0.05).In dichotomous unconditional Logistic regression,High school/technical secondary school above(OR=0.328,95%CI: 0.136~0.791),family per capita monthly income of more than 3201 yuan(OR=0.328,95%CI:20.136~0.791),previous illness(OR=0.328,95%CI: 20.136~0.791),pluripara(OR=0.314,95%CI:0.153-0.642),maternal and child health manual access to health education(OR=0.556,95%CI: 0.396~0.782)and emphasis on health education(OR=0.584,95%CI:0.405~0.844)were favorable influencing factors for maternal and infant health literacy level The knowledge of maternal health care is mainly obtained from the experience of professional medical staff,elders and relatives.46.63%(428/918)of the demand for maternal and infant health education is wechat public account education.Conclusions:1.The coverage rate of basic level child insurance in Guiyang is higher and the fairness is better.2.The hardware,human resources and service quality of children’s health care at primary level need to be improved.3.Parents have different emphasis on child service insurance needs in different periods.4.The overall health literacy level of rural pregnant women at the grassroots level is relatively low,and the demand for health education is relatively large.