【摘要】 目的:评价成熟避孕方法推广的综合措施对项目地区避孕方法选择及计划生育技术服务质量的干预效果。方法:在运用WHO提出的方案进行战略评估的基础上,根据评估结果2003年5月对重庆市和四川省眉山市项目现场开展行动研究,制定并逐步落实以优化避孕药具种类;加强技术人员业务培训,规范服务过程,提高服务质量;完善服务记录;更新群众宣教内容和改善管理制度等为主要内容的综合干预方案。2005年7月,运用一系列定性、定量研究方法对干预效果进行评价。结果:经过综合推广,TCu380A、MLCu375等安全高效的宫内节育器已成为项目试点地区主要使用的宫内节育器类型;药铜165以及长效口服避孕药等有效性、安全性欠佳的避孕药具使用人数逐年减少。计划生育手术前的血常规、白带常规等基本检查比例由基线评估时的基本空白提高到近100%。技术人员咨询知识与技巧大幅增加,手术质量明显改善,术后随访及对口服避孕药使用者的健康监测工作逐步受到重视,定期的环情孕情检查中增加了健康检查的内容,各种技术服务记录趋于完善,服务质量获得服务对象的认可,避孕失败意外妊娠率较往年低。结论:成熟避孕方法综合推广干预措施可以有效提高高效避孕方法的使用比例,并提高计划生育技术服务整体质量。更多还原

【Abstract】 Objective: To evaluate the effect of intervention effect which aimed to improve the approach of effective contraceptive methods and quality of family planning service in rural areas of China. Methods: This study was conducted in rural areas of Chongqing Municipality and the study sites of Sichuan Province from may 2003. Background information was collected with the methodology of Strategic Assessment of WHO Strategic Approach. Based on the findings of baseline strategic assessment, a series of intervention were developed and implemented in the study sites, including introducing new contraceptive methods; training service providers intensively (with standard procedure of service, counseling technique, laboratory test, etc); improving service record; providing broad mass education and bettering the monitoring system. A final evaluation was carried out in July 2005 through qualitative and quantitative research methodology. Results: After intervention, contraceptive methods recommended in the project, such as TCu380A and MLCu375 became the dominant contraceptives instead of the less effective medicated copperring 165 and once-a-month oral pill. Haemoglobin measuring and laboratory testing for reproductive tract infections(RTIs) were routinely performed before IUD insertion/removal or induced abortion surgery. Providers’ techniques of counseling and quality of surgical operation were improved. Follow-up and health check for contraceptive users, particularly for oral contraceptive users, were pervasively carried out. Abortions due to contraceptive failure were dramatically declined. Conclusions: The integrated intervention measure of the effective contraceptive methods can largely improve the adoption of effective contraceptive methods and the quality of family planning service.更多还原