我国部分地区妇幼保健机构儿童营养保健工作现状和需求调查分析

目的：了解各级妇幼保健机构在儿童营养保健方面的现状和需求,为研究和制定基层医疗机构儿童营养改善策略提供依据。 方法：在北京市和广西省各选取省、市、县及乡镇4个级别的8个妇幼保健机构,对专业技术人员进行问卷调查和专题小组讨论。 结果：各级妇幼机构的儿保医师,尤其是基层的儿保医师,对于儿童营养保健的制度、规范以及营养知识的掌握都存在一定的不足,对相关的营养知识有较强的需求。 结论：依据儿童营养保健的现状和医师的需求可制定用于基层医疗机构的儿童营养改善指南,以提高基层医师的儿童营养保健水平。     

不同妇幼保健模式对妇女保健效果的影响分析

目的:探讨不同妇幼保健模式对妇女保健效果的影响。方法:基于规模等同的条件下,选取我市三所妇保院为研究组,三所妇保所为对照组,分析对比两种不同机构妇幼保健效果。结果:研究组死亡率低于对照组(P0.05),孕产妇系统管理率、住院分娩补助率、叶酸补充率均高于对照组(P0.05),两组对比差异有统计学意义。结论:以临床结合保健的干预模式,可以提供更高的医疗和保健水平,保健医院的保健效果更值得肯定。     

军民融合区域协同医疗信息化平台的建设与应用

军民融合区域协同医疗信息化平台的主要功能包括公众服务、医疗机构协同、社区卫生保健、妇幼保健、政府管理决策支持及第三方服务等。信息化平台的应用有效缓解了“看病难、看病贵”的矛盾,推动医疗卫生机构的发展,强化卫生行政部门监管职能,促进了军队卫生事业的发展。     

风险管理对基层妇幼保健机构护理风险事件及孕妇心境状态的影响

目的探讨风险管理对基层妇幼保健机构护理风险事件及孕妇心境状态的影响。方法选取2018年1月～2019年12月在我院治疗的孕妇72例,按随机数字表法分为两组,每组36例。对照组实施常规管理干预,观察组实施风险管理干预,观察比较两组患者管理前后的SDS、SAS评分以及风险事件发生率、孕妇满意度。结果实施管理干预后,观察组的SDS、SAS评分低于对照组(P0.05),风险事件发生率低于对照组(P0.05),满意度评分高于对照组(P0.05)。结论基层妇幼保健机构实施孕妇风险管理有助于改善孕妇的不良心境,降低不良事件发生率,提高患者满意度。     

对构建中国第三方医院评审机构的思考和建议

讨论了中国第三方评审机构、设置方法,以及它与政府和其他有关机构之间的关系。评审机构最佳设置地点是高校。这样的设置不仅可使第三方评审迅速步入轨道,而且也有利于培养中国下一代医院评审专业人员和建立医院评审的长久机制。     

国家重点研发计划“现代食品加工及粮食收储运技术与装备”专项解析

国家重点研发计划“现代食品加工及粮食收储运技术与装备”是国家科技计划管理改革后首批启动的重点专项之一,从2016年起分3批部署了44个项目,投入中央财政资金11.63亿元。本文简要介绍了专项设立背景、研究基础、总体目标及项目设置,分析了承担单位立项数量及经费总量、承担单位地域分布以及项目主持人年龄特点等情况,建议优化专项立项流程,发挥第三方机构桥梁作用以及落实科技报告制度等完善专项组织实施的对策建议,为后续的科学管理提供参考。     

生物技术学:一个概述

Science(科学)的这一期是专门检查一下应用生物学革命的现状。在重组DNA和单克隆抗体的应用方面,进展一直是迅速的。人和动物的保健再过几年会发生实质性改善。     

生物多样性数据共享和发表: 进展和建议

生物多样性研究、保护实践、自然资源管理及科学决策等越来越依赖于大量数据的共享和整合。虽然关于数据共享的呼吁和实践越来越多, 但很多科学家仍然主动或被动地拒绝共享数据。关于数据共享, 现实中存在一些认知和技术上的障碍, 比如科学家不愿意共享数据, 担心同行竞争, 认为缺少足够的回报, 不熟悉相关数据保存机构, 缺少简便的数据提交工具, 没有足够时间和经费等。解决这些问题及改善共享文化的关键在于使共享者获得适当的回报(比如数据引用)。基于同行评审的数据发表被认为不但能够为生产、管理和共享数据的科学家提供一种激励机制, 并且能够有效地促进数据再利用。因而, 数据发表作为数据共享的方式之一, 近来引起了较多关注, 在生物多样性领域出现了专门发表数据论文的期刊。在采取数据论文的模式上, 数据保存机构和科技期刊采用联合数据政策在促进数据共享方面可能更具可行性。本文总结了数据共享和发表方面的进展, 讨论了数据论文能在何种程度上促进数据共享, 以及数据共享和数据发表的关系等问题, 提出如下建议: (1)个体科学家应努力践行数据共享; (2)使用DOI号解决数据所有权和数据引用的问题; (3)科技期刊和数据保存机构联合采用更加合理和严格的数据保存政策; (4)资助机构和研究单位应当在数据共享中起到更重要的作用。     

生物多样性和生态系统服务政府间科学政策平台第六次全体会议在哥伦比亚召开

正2018年3月17–24日,生物多样性和生态系统服务政府间科学政策平台(The Intergovernmental Science–Policy Platform on Biodiversity and Ecosystem Services,IPBES)第六次全体会议在哥伦比亚麦德林召开。来自各成员国、联合国机构、联合国环境公约和非政府组织的800多名代表参加了此次会议。我国派出由生态环境部、外交部、中国科学院等部门和单位代表组成的政府代表团参会。本次全体会议接受了联合国四大地理区域关于生物多样性和生态系统服务的四份评估报告、土地退化和恢     

我国高校遗传学教材的出版与使用现状的调查

利用国家图书馆“文津”搜索系统发现, 我国自恢复高考以来, 累计出版遗传学教材895部, 其中理论教材588部(65.7%)、实验教材122部(13.6%)、教学参考资料185部(20.7%)。这些教材中, 医学遗传学最多, 普通遗传学其次, 动植物微生物遗传学较少。对教材的名称、第一编(著)者和出版机构的分析发现, 名称为“医学遗传学”的教材有91部, 左伋教授编写了9部教材, 是编写教材最多的“第一编(著)者”, 科学出版社共出版了179部(占20%)教材, 是遗传学教材出版的主力军。利用问卷调查发现, 戴灼华等主编的《遗传学》(第二版)是目前使用最广泛的理论教材, 实验教材则多用自编讲义或教材。文章也对教材中存在的问题, 如更新周期长、配套落后、同名严重、遗传学故事写得太少、特色插图凤毛麟角、印刷页字数过满等进行了剖析, 并提出了解决途径。     

Health status and national health priorities.

Various measures of the health status of the population of the United States show there is considerable room for improvement. Compared with other industrialized nations, we are spending more for health care but our health is worse. These data form the basis for setting national priorities. Four selected policy issues are discussed, including access to medical care, maternal and child health care, the acquired immunodeficiency syndrome, and long-term care. Examination of these issues leads to the conclusion that universal and affordable health care is the major national health priority, requiring a commitment by the people of the United States and its leaders to develop a viable solution.     

Neonatal mortality and maternal health care in Nepal: searching for patterns of association

This study explores the factors associated with neonatal mortality and maternal health care in Nepal. The subjects were 4375 births reported in the 1996 Nepal Family Health Survey. Maternal and child health care was found to have a significant association with neonatal mortality, although preceding birth interval and sex of child had stronger effects. Four aspects of maternal care were found to be highly associated with region, household ownership of assets, mother's education and father's education. This indicates that accessibility, affordability and availability of maternal health care are important factors to consider in future research on neonatal mortality.     

Understanding the association between maternal education and use of health services in ghana: exploring the role of health knowledge

Summary This paper examines the role of health knowledge in the association between mothers' education and use of maternal and child health services in Ghana. The study uses data from a nationally representative sample of female respondents to the 2008 Ghana Demographic and Health Survey. Ordered probit regression models evaluate whether women's health knowledge helps to explain use of three specific maternal and child health services: antenatal care, giving birth with the supervision of a trained professional and complete child vaccination. The analyses reveal that mothers' years of formal education are strongly associated with health knowledge; health knowledge helps explain the association between maternal education and use of health services; and, net of a set of stringent demographic and socioeconomic controls, mothers' health knowledge is a key factor associated with use of health services.     

Analysis of the Maternal and Child Health Care Status in Suizhou City,Hubei Province,China, from 2005 to 2011

Background

Improving the health and well-being of women and children has long been a common goal throughout the world. From 2005 to 2011, Suizhou City had an annual average of 22,405 pregnant and parturient women (1.04% of the population) and 98,811 children under 5 years old (4.57% of the population). Understanding the status of maternal and child health care in Suizhou City during such period can provide the local health administrative department valid scientific bases upon which to construct effective policies.

Methods

Various types of annual reports on maternal and child health care were collected and analyzed retrospectively.

Results

Mortality rates for infants and children under 5 years showed a declining trend, while the rates of newborn home visiting, maternal health service coverage, and children health systematic management increased annually in Suizhou City from 2005 to 2011. The incidence of birth defect increased from 2.42‰ in 2005 to 3.89‰ in 2011. The maternal mortality ratio (MMR) fluctuated from 8.39/100,000 to 28.77/100,000, which was much lower than the national MMR (30.0/100,000 in 2010). The rates of hospitalized delivery and births attended by trained health personnel for pregnant women increased to more than 90% in the past five years.

Conclusions

The improvements in maternal and child health care work in Suizhou City are worthy of recognition. Thus, the government should continue to increase funding in these areas to promote the complete enhancement of the maternal and child health care system.     

Assessing the utilization of maternal and child health care among married adolescent women: evidence from India

This study explores the prevalence and factors associated with the utilization of maternal and child health care services among married adolescent women in India using the third round of the National Family Health Survey (2005-06). The findings suggest that the utilization of maternal and child health care services among adolescent women is far from satisfactory in India. A little over 10% of adolescent women utilized antenatal care, about 50% utilized safe delivery services and about 41% of the children of adolescent women received full immunization. Large differences by urban-rural residence, educational attainment, religion, economic status and region were evident. Both gross effect and fixed effect binary logit models yielded statistically significant socioeconomic and demographic factors. Women's education, wealth quintile and region are the most important determinants for the utilization of maternal and child health care services. Health care programmes should focus more on educating adolescents, providing financial support, creating awareness and counselling households with married adolescent women. Moreover, there should be substantial financial assistance for the provision of delivery and child care for married women below the age of 19 years.     

Assessing Community Based Improved Maternal Neonatal Child Survival (IMNCS) Program in Rural Bangladesh

Objectives

A community based approach before, during and after child birth has been proven effective address the burden of maternal, neonatal and child morbidity and mortality in the low and middle income countries. We aimed to examine the overall change in maternal and newborn health outcomes due the “Improved Maternal Newborn and Child Survival” (IMNCS) project, which was implemented by BRAC in rural communities of Bangladesh.

Methods

The intervention was implemented in four districts for duration of 5-years, while two districts served as comparison areas. The intervention was delivered by community health workers who were trained on essential maternal, neonatal and child health care services. A baseline survey was conducted in 2008 among 7, 200 women with pregnancy outcome in last year or having a currently alive child of 12–59 months. A follow-up survey was administered in 2012–13 among 4, 800 women of similar characteristics in the same villages.

Findings

We observed significant improvements in maternal and essential newborn care in intervention areas over time, especially in health care seeking behaviors. The proportion of births taking place at home declined in the intervention districts from 84.3% at baseline to 71.2% at end line (P<0.001). Proportion of deliveries with skilled attendant was higher in intervention districts (28%) compared to comparison districts (27.4%). The number of deliveries was almost doubled at public sector facility comparing with baseline (P<0.001). Significant improvement was also observed in healthy cord care practice, delayed bathing of the new-born and reduction of infant mortality in intervention districts compared to that of comparison districts.

Conclusions

This study demonstrates that community-based efforts offer encouraging evidence and value for combining maternal, neonatal and child health care package. This approach might be considered at larger scale in similar settings with limited resources.     

Association between Maternal and Child Dietary Diversity: An Analysis of the Ghana Demographic and Health Survey

Objective (s)

This study examined the association between maternal and child dietary diversity in a population-based national sample in Ghana.

Methods

The data for this analysis are from the 2008 Ghana Demographic and Health Survey. We used data obtained from 1187 dyads comprised of mothers’ ages 15–49 and their youngest child (ages 6–36 months). Maternal and child dietary diversity scores (DDS) were created based on the mother’s recall of her own and her child’s consumption of 15 food groups, during the 24 hours prior to the in-home survey. The same food groups were used to compose both maternal and child DDS. Linear regression was used to assess the relationship between the predicted outcome – child DDS -- and maternal DDS, taking into account child age and sex, maternal factors (age, education, occupation, literacy, empowerment, number of antenatal visits as an indicator of health care use), household Wealth Index, and urban/rural place of residence.

Results

There was a statistically significant positive association between child and maternal DDS, after adjusting for all other variables. A difference of one food group in mother’s consumption was associated with a difference of 0.72 food groups in the child’s food consumption (95% CI: 0.63, 0.82). Also, statistically significant positive associations were observed such that higher child DDS was associated with older child age, and with greater women’s empowerment.

Conclusions

The results show a significant positive association between child and maternal DD, after accounting for the influence of child, maternal and household level factors. Since the likely path of influence is that maternal DDS impacts child DDS, public health efforts to improve child health may be strengthened by promoting maternal DDS due to its potential for a widened effect on the entire family.     

Inequalities in Advice Provided by Public Health Workers to Women during Antenatal Sessions in Rural India

Objectives

Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India.

Methods and Findings

The District Level Household Survey (2007–08) was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%–72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice.

Conclusion

A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients, irrespective of their socioeconomic status.     

Canadian departments of pediatrics and family medicine: in need of family therapy?

Whether and how much the departments of pediatrics in Canadian medical schools collaborate with the family medicine departments in training for child care were the focus of a survey conducted in 1983-84. Responses to a questionnaire sent to department heads indicated that in general the most supportive relationships existed in the western provinces, with progressively more problems uncovered from west to east. The responses concerning the roles of pediatricians and family physicians paralleled this trend, with the western view being that pediatricians are consultants and not competitors for primary care. Many respondents supported the expansion of family medicine, particularly into ambulatory and behavioural areas. The data provide some cause for concern about the future health care of children, as the forecasted oversupply of physicians is likely to encourage competition rather than consultation between the two groups. Also, many Canadian pediatricians accept the US model of pediatrics, which includes primary care, although in Canada the ratio of family physicians to pediatricians is six times that in the United States, and Canadian specialists are concentrated in urban centres. This means that family physicians will continue to provide most of the child care in Canada and need adequate training. They also need to develop cooperative, supportive relationships with specialists in child health care to enhance appropriate referral patterns.     

Targeted Interventions for Improved Equity in Maternal and Child Health in Low- and Middle-Income Settings: A Systematic Review and Meta-Analysis

Background

Targeted interventions to improve maternal and child health is suggested as a feasible and sometimes even necessary strategy to reduce inequity. The objective of this systematic review was to gather the evidence of the effectiveness of targeted interventions to improve equity in MDG 4 and 5 outcomes.

Methods and Findings

We identified primary studies in all languages by searching nine health and social databases, including grey literature and dissertations. Studies evaluating the effect of an intervention tailored to address a structural determinant of inequity in maternal and child health were included. Thus general interventions targeting disadvantaged populations were excluded. Outcome measures were limited to indicators proposed for Millennium Development Goals 4 and 5. We identified 18 articles, whereof 15 evaluated various incentive programs, two evaluated a targeted policy intervention, and only one study evaluated an intervention addressing a cultural custom. Meta-analyses of the effectiveness of incentives programs showed a pooled effect size of RR 1.66 (95% CI 1.43–1.93) for antenatal care attendance (four studies with 2,476 participants) and RR 2.37 (95% CI 1.38–4.07) for health facility delivery (five studies with 25,625 participants). Meta-analyses were not performed for any of the other outcomes due to scarcity of studies.

Conclusions

The targeted interventions aiming to improve maternal and child health are mainly limited to addressing economic disparities through various incentive schemes like conditional cash transfers and voucher schemes. This is a feasible strategy to reduce inequity based on income. More innovative action-oriented research is needed to speed up progress in maternal and child survival among the most disadvantaged populations through interventions targeting the underlying structural determinants of inequity.