Privatisation of health services and the reproductive health of rural Chinese women
Privatisation of health services and the reproductive health of rural Chinese women
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DOI：
10.1016/s0968-8080(02)00090-3
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发表时间：
2002-11-01
影响因子：
--
通讯作者：
Jing, F
中科院分区：
文献类型：
--
作者：
Kaufman, J;Jing, F
自20世纪80年代初中国开始将农村卫生服务私有化以来，中国的农村卫生保健系统经历了重大变革。在财政权力下放之后，农村初级保健服务转变为收费服务制度，取决于当地资源的供应情况。本文报告了1994-96年在云南省两个农村县进行的一项研究的结果，以审查私有化对妇女生殖健康服务的筹资、提供和使用的影响。自我报告的最常见的生殖疾病症状是在家中分娩时阴道分泌物异常和阴道流泪，大多未经治疗。在医院分娩和利用产前护理的比例很低，这受到费用和质量低下的不利影响。服务质量受到对工人培训、维修和监督的低投资的影响。产妇和儿童保健的大部分负担落在当地保健工作者身上，然而，从1985年到1995年，用于这些服务的资源有所减少。只有对计划生育服务的支助有所增加，这些服务是单独供资和提供的。改革后，农村保健服务没有充分满足农村妇女的生殖健康需要。我们的数据有助于在计划的改革努力中提高对这些需求的关注。(C)2002年生殖健康问题。由Elsevier Science Ltd.出版，版权所有。
China's rural health care system has undergone major changes since the early 1980s, when the country began privatising rural health services. Following fiscal devolution, the rural primary health service was transformed into a fee-for-service system, dependent on the availability of local resources. This article reports some of the results of a study undertaken in 1994-96 to examine the impact of privatization on financing, provision and use of reproductive health services by women in two rural counties in Yunnan Province, China. The most common self-reported symptoms of reproductive morbidity were abnormal vaginal discharge and vaginal tears during home delivery, which went mostly untreated. Hospital-based delivery and use of antenatal care was very low, adversely affected by costs and perceived low quality. Service quality was affected by low investment in training, maintenance and supervision of workers. Most of the burden for maternal and child health care fell on local health workers, yet resources for these services had declined from 1985 to 1995. Only support for family planning services, which were funded and provided separately, had increased. Rural women's reproductive health needs were inadequately attended to by rural health services following reforms. Our data has helped to increase attention to those needs within planned reform efforts. (C) 2002 Reproductive Health Matters. Published by Elsevier Science Ltd. All rights reserved.