| ObjectiveUnlike the prevention and treatment of the strong infectious diseases,which were equally listed as the emphasis of the health work during the founding of the People' s Republic of China,t.he new-method delivery was not popularized until 1985.As it spanned several historical periods plus various of reasons,the new-method delivery is far from being as simple as the popularization of the vaccination.Therefore,it is the main research purpose of this project to study the historical process from the beginning of the implementation of the new-method delivery to its general popularization,to outline the social picture of the implementation of the new-method delivery,to explore the influential factors of the quick popularization of the new-method delivery,and to analyze the underlying reasons that affect the fluctuation of the new-method delivery rate.MethodsOn the basis of a large number of first-hand historical materials,guided by historical materialism with historical literature review methodology,this research systematically examined the whole process from the implementation until the general popularization of the new China' s new-method del ivery to outline its general history.Meanwhile,considering the development of the political,cultural and social backgrounds during the 36 years'implementation of the new-method delivery after New China' s foundation,with medical social history research methods,synthesizing the different influential factors,this research proclaim that the political movements,the economic level and the human resources are the important factors affecting the popularization of the new-method delivery,which in return affects the fluctuation of the new-method delivery rate.ResultsThrough analyzing each constructive element of the implementation the new-method delivery,such as the advocacy,the human resource,the promotion styles,and the organizational management,this thesis Completely combs the basic historical experience of the implementation of the new-method delivery and redisplay the history from the implementation to the popularization of new China' s new-method delivery.After reviewing and analyzing a large amount of data in various historical periods,it is found that the new-method delivery rate in the Great Leap Forward period has a false high component,and the medical care received by the rural delivery women during the Cultural Revolution(Hereinafter referred to as "C.R.")is not as little as the former scholar estimated.During the C.R.period,many middle and senior maternal and child health workers either participated in the traveling dispensary,or were delegated to the countryside,spreading the new-method delivery in rural areas at a certain extent.And the localized junior medical staff trained by them had also restored human resources for the quick promotion and generalization of the new-method delivery in later C.R..In the process of formulating the historical view of the implementation of the new-method delivery,through in-depth exploration of the historical materials,new perspectives are proposed on some aspects,such as the reformation of the old midwife,the maternal and child care staff training,and the midwifery education etc.Considering the development of the social system,the evolution track of the maternal and child health institutions is sorted out,in which the internal logic hidden is analyzed.With the extreme shortage of the rural medical staff,a huge amount of traditional Chinese medicine practitioners were attached great importance by the government,with their wide distribution,and were organized into the implementation work of the new-method delivery.In this thesis,the feature of the implementation of the new-method delivery in the ethnic areas is also analyzed,in which,from a policy environment perspective,it points out the decisive role played by the allocation of the medical resources.Based on collecting and analyzing the statistical data on the new-method delivery rate in different historical periods and regions,the wave trend of the new-method delivery rate is redisplayed lively.Through various analytical methods,such as the medical sociology and the demography,with an overall consideration of the influential factors of politics,society and economy on the implementation of the new-method delivery,it is proposed that the main reasons for the rise and fall and the long duration of 36 years to a general popularization are mainly due to the many transitions of the policy,the severe shortage of the human resources,the economic conditions lagging behind,and the traditional mentality of fertility.ConclusionOn the basis of sketching the historical feature of the new-method delivery,this thesis illustrates an overall summary of the main achievements and a general historical experience of the new China new-method delivery from the beginning to the general popularization,from which it reveals the main reasons for the long-term adoption of the new method and the inherent and external restraining factors underneath the fluctuation of the new-method delivery rate.Since the promulgation of "The Common Program of the Chinese People' s Political Consultative Conference" and the founding of the People' s Republic of China in September 1949,the protection of maternal and child health has been the consistent policy of the party and the government.In different historical periods,in conjunction with the focus of the work,a series of measures were taken,such as uniting and transforming the existing personnel,training new forces,vigorously promoting the new-method delivery,as well as establishing new-method delivery organizations and institutions in urban and rural areas,factories and mines.Works were carried out to annihilate the infantum tetanus and puerperal fever throughout the country,by uniting spots to areas,fanning out from spots to areas and successive carrying forward.Under the leadership of the party and the government,through the hard work of all the maternal and child care workers,the new-method delivery was generally popularized in the cities in 1959.Since then,the focus of the implementation work has turned to the countryside.The process of the implementation of the new-method delivery,with the interactive influence of various factors,has constituted its unique features.In the propaganda of the new-method delivery,in addition to educating people to abolish the feudal superstition,the focus was on stimulating people' s sense of identity with the new people's political power through contrast between the old and the new.In training midwives,there were skills training as well as distinctive era characteristics of land reform,cooperation,and rural cooperative medical care,from which traditional Chinese medicine could also be seen as a hidden or obvious influence.In the management of vocational qualifications,the specialization and certification system was strictly implemented from 1949 to 1957.Owing to the poor conditions in all aspects of the rural areas,all health personnel were required to do the new-method delivery work in 1958.In 1963,it was formally raised that as long as the disinfection delivery method with disinfecting cutting of the umbilical cord was adopted,the delivery work even by the family members or the neighbors would be counted as new-method delivery,which in fact,weakened the supervision of the midwives qualifications and reduced the technology requirements to the uttermost.After 1978,in the remote and economically underdeveloped areas,the practice from 1963 was promoted,which increased the implementation speed of this low-technology-based new method delivery,but to a certain extent affected the quality and the rate stability of it.Although there was the revocation of a large amount of maternal and child care institutions in the C.R.which affected the implementation,the consequence was the high quality resources went down to and improved the health level of the maternity and child in some rural areas due to the pre-instructions of focusing of health work into the countryside and the transformation of a big quantity of middle and senior medical health care staff including the gynaecology and obstetrics experts in the "Cultural Revolution".After the reform and opening up policy,the new-method delivery has been quickly popularized throughout the country because of the adoption of a diversified,multi-level and multi-channel approach to the implementation of the new-method delivery,coupled with the gradual improvement of the rural economy,the medical equipments and the professionals being generally in place,and the maternal and child health network being generally formed. |
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