国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2011, Vol. 30 ›› Issue (1): 50-53.

• 论著 • 上一篇    下一篇

中国西部县乡级计划生育服务机构宫内节育器服务及管理现况调查

贾贤杰,游顶云,高一飞,周洁,速存梅,杨瑶,赵敏,张开宁   

  1. 233030 蚌埠市，蚌埠医学院（贾贤杰）；昆明医学院（游顶云，周洁，速存梅，杨瑶，赵敏）；南方医科大学（高一飞）； 中山大学健康与人类发展研究中心（张开宁）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2011-01-15 发布日期:2011-01-15
  • 通讯作者: 张开宁

Enhance the Management of IUD Services in Family Planning Clinics at County and Township Level in Western China

China JIA Xian-jie，YOU Ding-yun，GAO Yi-fei，ZHOU Jie，SU Cun-mei，YANG Yao，ZHAO
Min，ZHANG Kai-ning.   

  1. Bengbu Medical College，Bengbu 233030，China（JIA Xian鄄jie）；Kunming Medical College，Kunming 650031，China （YOU Ding鄄yun，ZHOU Jie，SU Cun鄄mei，YANG Yao，ZHAO Min， ZHANG Kai鄄ning）；Southern Medical University, Guangzhou 510515，China（GAO Yi鄄fei）；Research Center for Health and Human Development, Sun Yat鄄sen University，Guangzhou 510275，China（ZHANG Kai鄄ning）
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-01-15 Online:2011-01-15
  • Contact: ZHANG Kai-ning，

PDF (PC)

7385

摘要： 目的：了解中国西部县乡级计划生育服务机构宫内节育器（IUD）放置服务与管理特点，
并探讨其成因，为有效提高县级IUD 放置服务质量提出建议。方法：根据国家计划生育优质服务县的标准
将云南省129 个县分为“好”、“中等”、“差”3 层，每层抽取1 个县，进行横断面调查。采用情景分析方法，收
集与IUD 放置服务和管理相关的数据及资料，并进行深入分析。结果：①计划生育服务机构平均放置IUD
种类，县级为（6.17±2.55）种，乡级为（4.08±0.92）种，县级多于乡级（Z=2.37，P=0.023）。②计划生育服务机
构人员平均每年人均放置IUD 数量，县级为（129.83±47.42）个，乡级为（288.75±35.18）个，县级低于乡级
（F=22.26，P<0.000 1）。此外，县级仍在使用一些失败率较高的IUD类型（如某些T 型环）。③定性研究结果
表明，西部农村IUD 失败率较高，与县计划生育服务机构IUD 放置服务的管理粗放有密切关系，放置人
员与管理人员间沟通、IUD的采购和机构文化都有很大改进空间。结论：西部县计划生育服务机构可通过
适当控制IUD 种类数和强化IUD服务管理提高服务质量。

关键词: 计划生育服务, 卫生保健质量, 宫内避孕器, 横断面研究, 云南

Abstract: Objective: 1. To identify the key elements of IUD（intrauterine devices）services in family
planning（云孕）clinics at county and township level in western China in order to explore the reasons leading to a
higher failure rate of IUD use compared with the lower level FP clinics. 2. To provide recommendations for
enhancing FP service quality at the county level. Methods：Using situation analysis, a cross鄄sectional study
was undertaken in FP clinics within three counties, which were randomly selected out of 129 counties in
Yunnan province. Both quantitative and qualitative methods were adopted in data collection and analysis. Results: Averagely，6.17依2.55 types of IUDs were used in FP clinics at county level, while 4.08依0.92 types of
IUDs were used at township level , which showed a significant difference（Z=2.37，P=0.023）. Compared with
the clinics at township level, lower proportion of IUDs were used in FP clinics at county level recommended by
national committee based on evidences of lower failure rate. Moreover, certain types of IUD being reported a
high failure rate were still used in county level clinics. The annual number of IUD insertion cases provided by
a county FP clinics was averagely 129.83依47.42, while the number was reported 288.75依35.18 at town level,
which showed a significant difference （F=22.26，P<0.000 1）. It was implicated that weaknesses in service
management existed, such as the absence of effective communication between service providers and managers,
which may contribute to the use of inappropriate types of IUD and undermine the quality of services. Conclusions: FP clinics at county level in western China should improve service quality by controlling the
types of IUDs properly and strengthening the IUD services management.

Key words: Family planning services, Quality of health care, Intrauterine devices, Cross鄄sectional studies, YUNNAN