Abstract: Objective To investigate the effects of intervention for basic maternal and child health services in Songjiang district of Shanghai,and provide the advice for effectively improving utilization of maternal and child health services. Methods The investigation subjects were mothers who took their babies aged one year to one and a half years to utilize basic child health service in all of fifteen community health service centers in Songjiang District during the survey time.In June to July 2013,the baseline investigation was conducted.In March 2013,the intervention was implemented,which mainly was free medical examinations for children aged 0~6 years old.In July to September 2014,the terminal investigation was conducted.The differences of awareness on the intervention and basic child health services utilization between two investigations were analyzed. Results Before and after the intervention,the proportion of investigated children who established examination cards were 87.5% and 92.2% respectively,the proportion of investigated children who took more than three physical examinations in the first year of their life were 86.8% and 92.0% respectively,and the proportion of awareness on the intervention were 62.6% and 75.1% respectively.The migrant population increased significantly.Multivariate analysis showed that both the intervention awareness and the intervention were related to the proportion of investigated children who took more than three physical examinations in the first year of their life,whose OR were 4.126 (P<0.001) and 1.875 (P=0.014) respectively. Conclusion The intervention is effective for improving basic health services' utilization,especially on migrant population.In the future,the awareness on intervention,the compensation method and service quality should be improved.

Key words: child health services, patient acceptance of health care, intervention studies

摘要： 目的 评价上海市松江区基本妇幼保健服务项目的效果,为有效提高妇幼保健服务的利用提供依据。方法 本项目以上海市松江区基本儿童保健服务利用者为实施对象。调查对象为调查时间内区内15个社区卫生服务中心接受基本儿童保健服务的1岁~1岁半儿童母亲。2013年3月实施项目,同年6-7月进行基线调查,措施主要为0~6岁儿童免费体检。2014年7-9月进行终末调查,分析项目实施前后项目知晓率和基本儿童保健服务利用情况的差异。结果 项目实施前后,儿童建卡率分别为87.5%、92.2%,儿童1岁以内≥4次体检率分别为86.8%、92.0%,项目知晓率分别为62.6%、75.9%,主要体现在非户籍人群上升显著。多因素Logistic回归发现项目知晓和项目实施均对儿童1岁以内≥4次体检率有统计学意义,OR分别为4.126(P<0.001)、1.875(P=0.014)。结论 项目对提高基本妇幼保健服务利用有一定的效果,其中非户籍人口的提高更为显著。但今后仍需提高项目的知晓率,改善补偿方式,提升服务质量。

关键词: 儿童保健服务, 卫生服务利用, 干预研究