偏远地区少数民族孕产妇精准管理模式构建及干预策略优化研究—基于社区参与和交叉性理论

少数民族人群的卫生公平问题已经被国际社会普遍关注。本研究针对中国西部偏远地区少数民族孕产妇卫生服务利用低的现状，依托西南区域高海拔世居高原自然人群队列研究，拟在云南省少数民族聚集的山区县，以社区为基础的参与式研究为主要方法，对社区的各利益相关者开展深入访谈、小组讨论等定性研究，以交叉性理论为分析框架，甄别出偏远地区少数民族孕产妇寻求和接受妇幼卫生服务的主要障碍；遴选、优化目前的干预措施，构建得到社区、家庭、妇女共同认可的针对偏远地区少数民族孕产妇的全过程、综合性、个体精准化的管理模式，改善基层妇幼卫生人员的工作方式和孕产妇的健康行为方式；采用专家咨询构建基层卫生机构开展少数民族孕产妇精准管理能力的评估指标体系，开展现场调查对偏远地区少数民族孕产妇精准管理模式的可行性、可持续性进行初步论证。为国内外缩小少数族裔人群健康差距、促进健康公平的政策制定提供依据。

Health inequality among ethnic minorities has already caused the widespread attention globally. Low utilisation of maternal health services exists among ethnic minority women in remote areas of western China. Based on the Cohort Study of Natural Population at High Altitude in Southwest China, this study will take community-based participatory research as the main method to identify the main obstacles to seeking and receiving maternal health services in mountainous ethnic areas of Yunnan Province by carrying out in-depth interviews and group discussions with stakeholders in community. The qualitative data will be analysed by using the intersectional approach as the analytical framework. Community participatory approach will be employed to select and optimize intervention strategies, and to build a community-family-individual acceptable precision management for ethnic minority pregnant women in remote areas which cover whole process of pregnancy. It aims to improve the works of maternal health workers at primary level and change the health behaviour of pregnant women. The evaluation index system of ability to provide precision management for ethnic minority pregnant women in primary health institutions will be established by expert consultation. The on-the-spot survey will be carried out to assess the feasibility and sustainability of the precision management for ethnic minority pregnant women in remote areas, and to provide evidence for policy making to reduce the health disparities and promote health equity for ethnic minorities.