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目的:了解偏远农牧区藏族育龄妇女的孕产期保健服务可及性状况。方法:利用2009年在青海省玉树县及囊谦县大、小苏莽乡的现场调查数据,分析农牧区藏族育龄妇女的孕产期保健服务利用率与经济、教育、医疗卫生服务可及性等因素的关系。结果:仅12.4%的妇女受过孕产期保健知识教育。最近一次生孩子孕产期保健服务利用率低,产前检查率为49.1%,新法接生率为11.2%,住院分娩率为9.5%,产后访视率为6.5%,均低于同类地区;怀孕期间发生紧急情况,60.4%的妇女会求助村医或乡医;生孩子后身体出现不适,68.6%的妇女会求助村医或乡医。受过孕产期保健知识教育者服务利用率高于未受过教育者;家庭年收入较高的妇女,在怀孕期间出现紧急情况和分娩后身体不适时,求医率高于家庭年收入较低的妇女。服务利用率与到医疗机构采用的不同交通方式和所需时间长短没有明显关系。调查地区67.3%的妇女生孩子无医药费用;有费用者,其自付医药费用占家庭年收入的比例在60%～100%者占5.7%,有2.9%的妇女生孩子自付医药费用超过了过去一年的家庭总收入。受访者报告了在过去2年内有4例亲属在孕产期死亡。结论:偏远农牧区藏族妇女在孕产期保健教育、服务等方面可及性不足。应进一步促进偏远农牧区的经济发展,倡导先进的生育文化,普及育龄妇女孕产期保健知识教育,加强乡村医生孕产期保健服务能力。
Objective: To understand the status of maternal health care accessibility of Tibetan women of childbearing age in remote rural areas. Methods: Based on the field survey data of Yushu County and Xiazao Mang Township in Yushu County of Qinghai Province in 2009, this paper analyzed the maternal health service utilization rate and economic, educational and health services of Tibetan women of childbearing age in rural and pastoral areas Sex and other factors. Results: Only 12.4% of women received knowledge of maternal health education. The rate of prenatal check-up was 49.1%. The new birth rate was 11.2%, the hospital delivery rate was 9.5%, and the postpartum visit rate was 6.5%, both of which were lower than those in the same area. Pregnancy During the emergency, 60.4% of women sought help from village or village doctors. After having children, 68.3% of women turned to village or village doctors for help. The utilization rate of services for educators with knowledge of motherhood was higher than that of uneducated women; women with higher annual household income had higher rates of seeking medical attention than those with lower annual household incomes during emergencies during pregnancy and after maternal physical discomfort Women. Service utilization is not significantly related to the different modes of transport and the length of time required to go to a medical facility. 67.3% of the women surveyed had no medical expenses for their children; those who had costs, their medical expenses accounted for 60% to 100% of the annual household income accounted for 5.7%, 2.9% of the women had children to pay medical expenses The total family income over the past year. Respondents reported that 4 relatives died during pregnancy in the past 2 years. Conclusion: Tibetan women in remote farming and pastoral areas have inadequate access to maternal health education and services. We should further promote the economic development in remote rural areas and pastoral areas, advocate advanced fertility culture, popularize the knowledge of maternal health education for women of childbearing age, and strengthen the capacity of rural doctors in providing maternal health care services.