Comprehensive evaluation of the quality of maternal and child health care of all counties in China
CHENG Zhihao, ZHOU Yubo, LUO Shusheng, LI Hongtian, LIU Jianmeng
Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health/Office for National Maternal and Child Health Statistics of China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Abstract：Objective To evaluate the overall quality of maternal and child health care of all counties in China, as well as to identify the relatively weaker counties and their weak links to provide references for the targeted assistance of maternal and child health care.Methods An evaluation index system was established by using the combined method of literature review and expert consultation, by screening indicators of National Maternal and Child Health Statistics (NMCHS). Weighted rank-sum ratio (RSRw) method was adopted to obtain the comprehensive measure towards the RSRw of each county. According to the values of RSRw, all counties were ranked and further sorted into four categories (The first category had the best quality of maternal and child health care, and the fourth category had the weakest). Analysis of spatial distribution and individual indicator level were performed among the fourth category counties and the weakest 100 counties, with the lowest quality of maternal and child health care in China (called as “100 counties”).Results 11 indicators were included in the analysis. The RSRw values of 2,876 counties in China ranged from 0.0053 to 0.8915, and the numbers of four categories of counties were 720, 719, 718, and 719, respectively. The fourth category counties and “100 counties” were mainly distributed among the rural (606 and 95, accounting for 84.3% and 95.0% respectively) and the western region (414 and 92, accounting for 57.6% and 92.0% respectively). The maternal mortality rates of the fourth category counties (21.1/100,000) and “100 counties” (43.9/100,000) were 1.7 and 3.6 times as high as the national average level (12.2/100,000) respectively. The under 5 mortality rates (7.0‰, 14.2‰) were 1.5 and 3.0 times as high as the national average level (4.8‰) respectively.Conclusion The weaker counties were mainly distributed among the rural and the western region with a relatively poor level of economic development. Reducing the maternal mortality rate and the under 5 mortality rate through comprehensive measures remains the key task for the weaker areas. In the new period, it is of significance to explore the targeted assistance of maternal and child health care and develop particular policies to ensure that all the people share the development achievements.
程志浩, 周玉博, 罗树生, 李宏田, 刘建蒙. 中国区县级妇幼保健水平综合评价研究[J]. 中国生育健康杂志, 2020, 31(4): 305-309.
CHENG Zhihao, ZHOU Yubo, LUO Shusheng, LI Hongtian, LIU Jianmeng. Comprehensive evaluation of the quality of maternal and child health care of all counties in China. Chinese Journal of Reproductive Health, 2020, 31(4): 305-309.
