Accessibility to delivery care in Hubei Province, China
Accessibility to delivery care in Hubei Province, China
复制标题
中国湖北省分娩护理的可及性
DOI：
10.1016/j.socscimed.2020.113186
复制
发表时间：
2020
影响因子：
5.4
通讯作者：
Cheng Yang
中科院分区：
文献类型：
--
作者：
Tao Zhuolin;Cheng Yang
获得分娩护理对于改善孕产妇健康至关重要，这是确保中国和世界各地健康生活和促进福祉的重要政策目标，特别是随着2016年中国计划生育政策的变化。本研究建立了一套预测湖北省育龄妇女人口和出生人口的方法，并对分娩保健服务的可及性进行了评价。本研究采用多假设情景的队列成分预测法，预测2030年的育龄妇女人口。针对不同地区、不同服务水平下的集水面积异质性和距离衰减效应，提出了一种基于重力的可变两步浮动集水面积（GV2SFCA）计算方法。通过使用具有患者地址的医疗记录来校准参数。传统的供需比方法也适用。结果表明，湖北省出生人口在所有情景下总体呈下降趋势，但地区差异显著。2016年，28%的地区未能达到每千名新生儿17张床位的政策目标。到2030年，预计98%的地区将增加分娩护理的可及性，但仍有22%的地区未能实现政策目标。可获得性分数进一步与出生人口密度相结合，以确定分娩护理的短缺领域。2016年和2030年，分别有7%和6%的地区被列为主要短缺地区。研究结果揭示了湖北省分娩服务可及性和短缺领域的分布和未来变化，为规划和决策提供了循证建议。它还提供了更准确地评估分娩护理可及性的创新方法。
Accessibility to delivery care is crucial for improving maternal health, which is an important policy goal to ensure healthy lives and promote well-being in China and worldwide, especially with the change of the family planning policy in China in 2016. This study develops a set of methods to project the population of women of child-bearing age and birth population and assess the accessibility to delivery care services in Hubei Province. The Cohort-Component projection method with various scenarios was applied to project the population of women of children-bearing age in 2030. A Gravity-based Variable Two-Step Floating Catchment Area (GV2SFCA) method is developed, which takes into account the heterogeneous catchment areas and distance decay effects for different regions and various levels of delivery care services. The parameters are calibrated by using medical records with patients’ addresses. The traditional Supply-Demand Ratio method is also applied. The results demonstrate an overall decreasing trend of birth population in Hubei in all scenarios, but with significant disparities across regions. In 2016, 28% of districts fail to reach the policy goal with 17 beds per thousand births. In 2030, accessibility to delivery care is projected to increase in 98% of districts, while there are still 22% of districts that fail to reach the policy goal. The accessibility scores are further combined with the densities of birth population to identify shortage areas of delivery care. 7% and 6% of districts are classified as Major Shortage Areas in 2016 and 2030, respectively. The findings shed lights on the distributions and future changes of accessibility to and shortage areas of delivery care in Hubei, which can provide evidence-based recommendations for planning and policymaking. It also provides innovative methods for more accurately assessing accessibility to delivery care.