Objective To investigate the full coverage of maternal health management to carry out three years to carry out effect in Baoshan District. Methods Health management indicators were compared and analysed, such as maternal mortality trends of Baoshan District full coverage of maternal health management programme promotion and maternal. Results ①Established pregnancy monitoring mechanism and pregnancy monitoring network, participated of 376 house appoint and 520 people, maternal monitoring programme was implemented for 3 years, platoon traces of 2930 area of nonlocal women who did not enter the health management system, which had not been the establishment of Shanghai City Maternal Health Care Handbook of 838 cases, who followed-up integrated into the health management.② pregnancy risk assessment mechanism was implemented, which the deadline was 2011 December, community health service centers were screened from 4875 people, in which the red 6 people of warning, 234 people of orange signal warning, 4598 people of yellow warning, 37 people of purple warning. Nonlocal key pregnant women were 3189 people, which accounted for 65.5% of the total number.③maternal health management index was upgraded with statistical significance (P < 0.05). ④pregnancy risk assessment mechanism was carried out 3 years, maternal mortality rates had decreased, especially nonlocal maternal death and prior to project implementation had decreased. ⑤according to training, it improved postpartum visit theory knowledge and interview skills, strengthened the visiting quality assessment, implementation of the postpartum visit on behalf of access network management. Conclusion ① since the implementation of full coverage of maternal health management plan, it improves the maternal health management network, so that the maternal health management indicators comprehensive promotion. ② the pregnancy risk forecast and assessment mechanism improves the management quality of high risk pregnant women, and reduces the mortality of maternal and perinatal fetus. ③cover the whole area of midwifery and infrastructure network, it improves the efficiency for rescuing critically ill pregnant women, and the quality of medical treatment. ④ puerperium realize the postpartum visit turnover generation network, it improves the postpartum visit quality and postpartum visits the timeliness and the postpartum visit rate ⑤ full coverage of maternal health management, it exerts a powerful influence over improving maternal health service fairness and availability.%目的 探讨宝山区<全覆盖孕产妇系统保健管理>推行3年的实施效果.方法 对比分析宝山区<全覆盖孕产妇系统保健管理方案>推广前后孕产妇系统保健管理指标,孕产妇死亡率等的变化趋势.结果 ①建立孕情监测机制及孕情监测网络,376个居委520人参与,孕情监测方案实施3年排摸2930名辖区内外来孕妇未进入保健管理系统,其中未建立上海市孕产妇保健手册838人,追踪随访纳入保健管理.②妊娠风险预警评估机制实施,截至2011年12月,社区卫生服务中心共筛查4875人,其中红色预警:6人,橙色预警234人,黄色预警4598人,紫色预警37人.外来重点孕妇3189人,占总筛查数65.5%.③孕产妇系统保健管理指标全面提升,差异有统计学意义(P < 0.05).④妊娠风险预警评估机制实施3年,孕产妇死亡率曾明显下降趋势,尤其外来孕产妇死亡与项目实施前比较有明显下降.⑤通过培训提高产后访视理论知识和访视技能,加强访视质量评估,实现产后访视代访网络化管理.结论 ①<全覆盖孕产妇系统保健管理方案>全面推广实施以来,健全完善了孕产妇系统保健管理网络,使孕产妇系统保健管理各项指标全面提升.②<实行妊娠风险预警评估机制>提高了高危孕妇管理质量.降低孕产妇、围产儿死亡率.③完善覆盖全区助产及基层机构网络,提高危重孕产妇的救治效率,及救治质量.④产褥期保健,实现产后代访周转的网络化,提高了产后访视质量和产后访视的及时性及产后访视率.⑤全覆盖孕产妇系统保健管理,对提高孕产期保健服务的公平性和可及性起到了极大的作用.
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