Abstract: 【Objective】 To evaluate the effect of integrated health-care interventions for children under 5 years old in target rural counties of Shaanxi Province and to provide experiences and lessons for following projects. 【Methods】 From 2007 to 2010, a project focusing on maternal and child health care was launched in targeted rural areas of Shaanxi Province, with integrated interventions. Together with using multistage, stratified, randomly, non-probability sampling, two cross-sectional surveys were conducted in 2006 and 2010, and a before/after intervention design was used to assess the effectiveness of the integrated interventions by changes in children's growth and development, health outcome, guardians' health-related knowledge and behavior. 【Results】 The decrease in the stunting rate was more than 50% after intervention(6.9% to 3.4%, P<0.01). The rate of anemia was still high and also little effect had been shown in reduction of both two-week prevalence of suspected pneumonia and two-week prevalence of diarrhea(P>0.05). However, there was significant improvement in health awareness and behavior among caregivers, especially the rate of professional care-seeking when either of the disease occurred increased dramatically to more than 85%. 【Conclusions】 This project, to some extent, has promoted the health of children under 5 and the level of health care, but little effect showed in the reduction of anemia, suspected pneumonia and diarrhea. So it is still urgent to seek more specific and targeted interventions fighting against such problems and to improve intensity of interventions as well.

Key words: children under 5 years old, growth and development, intervention, evaluation

摘要： 【目的】 对陕西省部分地区5岁以下儿童健康干预的效果进行评价,为后续项目提供经验。 【方法】 于2007-2010年间开展包括“母子系统保健项目”,采用不等概率抽样方法,分别在2006年和2010年开展基线和终末两次横断面调查,通过对干预前后5岁以下儿童生长发育、健康结局、看护人保健认知与行为指标进行比较,对项目的干预效果进行评价。 【结果】 儿童生长迟缓率在项目干预后下降至少50%,由6.9%降低到3.4%(P<0.01);儿童贫血检出率、近两周疑似肺炎患病率与近两周腹泻率均未有明显降低(P>0.05);看护人保健认知及儿童就医行为在项目后有明显改善,两种疾病患病后就诊率在干预后均提高到85%以上。 【结论】 项目的干预措施在一定程度上促进了项目地区5岁以下儿童健康及保健水平,但儿童的贫血问题依然严峻,腹泻、疑似肺炎患病率降低不明显,需进一步结合地方突出问题,细化各种干预措施,加大干预强度。

关键词: 5岁以下儿童, 生长发育, 干预, 评价