The Trend Research On The Health And Care Service Situation Of Women And Children In Gansu Province

ObjectiveTo analyze change tendency of the main parameters with the health and care service situation of women and children in Gansu province. To determine the prominent question this affected health situation of women and children. The results will provide scientific basis for making health care strategies and intervention measures of women and children in Gansu province.MethodChoose the data from the maternal and child surveillance (1996-2007) and annual report (1992-2007) in Gansu province. Analyze the health situation of women and children, and care service situation of maternity and children. Based on the related data of Chinese Health-Statistics of 2000 and 2008, and the "National Maternal and Child Surveillance" (1996-2004), compare analysis the health situation between the whole nation and Gansu province. Evaluate change tendency of the main parameters with the health situation of women and children by using estimated average annual percent change (EAPC).Results1. Trend analysis on the health and care service situation of maternal in Gansu province:(1) The death situation and trend analysis of maternal:①The maternal mortality rate:The maternal mortality rate in entire province, city and rural areas had dropped 48.07%,30.42%, and 45.38%in turn from 1996 to 2006 in Gansu province. The rate was higher in rural than in city (x2=19.201, p<0.01). Compared with the national level, the rate in entire province, city and rural areas were still higher. The maternal mortality rate of class 5 district was higher than that of other class district in 1992 to 2007, the difference had statistical significance between all classes of district (x2=579.506,p<0.01).②Constitution of primary death causes:Obstetric hemorrhage and hypertension during pregnancy were primary causes of pregnant death.③The death trend analysis:The maternal mortality rate in entire province, city and rural areas had negative correlation with years (p<0.05), their estimated average annual percent change (EAPCs) had statistical significance (p<0.05). The maternal mortality rate of all classes of district (except class 1 district and class 2 district) had negative correlation with years(p<0.05), their estimated average annual percent change (EAPCs) had statistical significance (p<0.05). (2) Maternal care service:The main parameters of maternal care service, such as the rate of early pregnancy examine, the rate of antenatal examine, the rate of postpartum visits, system administration rate, the utilization rate of new delivery methods, the rate of hospitalized childbirth, all raised somewhat from 2000 to 2007. The increasing rang was significant in rural areas. Especially with the rate of hospitalized childbirth, it had an increase of 54.71%.2. The prevalence rate and syn position of gynecological disease in Gansu province: (1) The prevalence rate of gynecological disease:The prevalence rate fluctuated from 2000 to 2007. The rate was higher in rural than in city. Compared with 2000, the drop rang were not big in entire province, city and rural areas separately in 2007. (2) Syn position of gynecological disease:Trichomonas vaginitis and cervical erosion ranked the first and second place in various gynecological diseases alternately. The prevalence rate of cervical cancer was higher than that of breast cancer and ovarian cancer in the most common cancers.3. Trend analysis on the health situation and care level of children in Gansu province: (1) The health situation and trend analysis of children:①The death situation and trend analysis of child under age 5:1) The mortality rate of child under age 5:The mortality rate of neonatal, infant and child under age 5 had dropped 50.08%,45.26% and 49.49%in turn from 1996 to 2007. The rates were higher in rural than in city. Compared with the national level, the rates were still higher. The mortality rate of neonatal and infant of class 5 district from 1992 to 2007 were higher than those of other class district, the differences had statistical significance between all classes of district (p<0.05).2) The main death causes sequences of child under age 5:The main death disease categories with child under age 5 were birth asphyxia, pneumonia premature, delivery or low birth weight.3) The death trend analysis:The mortality rate of neonatal, infant and child under age 5 in entire province, city and rural areas had negative correlation with years(p<0.05), their estimated average annual percent change (EAPCs)had statistical significance (p<0.05). The mortality rate of neonatal and infant of all classes of district had negative correlation with years(p<0.05), their estimated average annual percent change (EAPCs) had statistical significance (p<0.05).②Incidence rate and death rate of newborn baby tetanus:Incidence rate and death rate of newborn baby tetanus presented decreasing trend during 2000-2007. It had declined to below 1‰in 2007.③The nutritional status of child under age 5: Incidence rate of preterm delivery and low birth weight with child under age 5 had dropped during 2000-2007, the rate was 3.09%in 2007. Prevalence rate of suffering serious malnutrition with children under age 5 was still in a downward trend, the prevalence rate was higher in rural than in city. (2) Children care service:The main parameters of children care service, such as the rate of neonatal visiting, system administration rate of child under age 3 and child under age 7, all raised somewhat from 2000 to 2007. The increasing rang was significant in rural areas.4. The incidence rate and trend analysis of birth defects in Gansu province:(1) The incidence rate of birth defects:The incidence rate of birth defects in entire province, city and rural areas had dropped 14.01%,34.44%and 5.01%in turn from 1996 to 2007. The rate was higher in rural than in city (x2=229.293,p<0.01). The incidence rate of birth defects of female (118.58/10000) was higher than that of male (96.70/10000) (x2=24.544, p<0.01). (2) The sequences of occurences:Neural tube defects ranked the first place of the sequences of occurences of birth defects, the incidence rate fluctuated within the range of 24.99/10000 to 41.81/10000. Congenital hydrocephalus and cleft lip ranked second and third alternately. (3) Trend analysis on the incidence rate of birth defects:The rate fluctuated from 1997 to 2007. The rate in entire province, city and rural areas had no correlation with years (p>0.05). The change trend was unstable.Conclusion1. The health and care service situation of women and children had improved a lot during the recent years in Gansu, but the problem still allowed of no to neglect. The maternal mortality rate and child mortality rate had decreased year by year. The main parameters of maternal and children care service presented increasing tendency as a whole. Rise range was bigger, especially in rural areas. But compared with the national level, maternal mortality mate and child mortality rate were still higher. Their speeds of decline were relatively slow conditions and showed "the plateau phase". The incidence rate of birth defects presented an unstable variation trend during 11 years.2. There were distinct gaps between city and rural areas and between regions on the health situation with women and children in Gansu province. The maternal mortality rate, child mortality rate, the incidence rate of birth defects were higher in rural than in city. The maternal mortality rate, mortality rate of neonatal and infant of class 5 district were higher than those of other class district from 1992 to 2007. In order to further bring down maternal mortality rate and child mortality rate, the women and child health care should be strengthened in rural areas as well as class 5 district.3. The prominent question affected health situation of women and children. Obstetric hemorrhage and hypertension during pregnancy were primary causes of pregnant death. Infectious diseases ranked the first place in various gynecological diseases. The prevalence rate of cervical cancer was higher than that of breast cancer and ovarian cancer in the most common cancers. The main disease categories which caused child under age 5 deaths were birth asphyxia, pneumonia, and premature delivery or low birth weight. Neural tube defects ranked the first place of the sequences of occurences of birth defects.