预防艾滋病母婴传播项目多部门协作机制研究

摘要

Objectives To explore the multi-sector cooperative mechanisms of PMTCT program (Prevention of Mother-to-Child Transmission Program of HIV) in Shenzhen and to provide scientific evidence for government policy. Methods Focus Group Discussion (FGD) and In-depth Interviews were conducted on a qualitative study carried out among healthcare providers from the municipal and district CDCs, the Maternal & Child Health Hospitals, Shenzhen Third People's Hospital and other Implementation Hospitals. Results There existec both vertical leadership and vertical coordinating mechanisms among the municipal PMTCT office, the district PMTCT office and the Implementation Hospitals in the program management and follow-ups of the HIV positive women and their children respectively. Multidivisional coordinations lied among the CDCs, the Maternal & Child Health Hospitals and Shenzhen Third People's Hospital in the program training, monitoring, comprehensive intervention, information management and antiretroviral prophylaxis. As to 2010, more than 1. 7 million pregnant women had received HIV testing and the HIV testing rate accounted for 96. 2%. Among those women who knew their HIV-infection status during pregnancy and carried to delivery, 91. 3% mother-children pairs received ARV prophylaxis. Among women identified as HIV positive during labor, 72. 4% infants received ARV prophylaxis. 74. 3% HIV exposed infants received follow-up HIV virus tests. Conclusions The cooperative horizontal and vertical organizational structure of Shenzhen PMTCT program is effective and efficient for the highly integration of public health resources.%目的 了解深圳市预防艾滋病母婴传播项目多部门分工协作的运行机制,为政府相关决策提供建议.方法 对深圳市及区疾控中心、妇幼保健院、市三院等13家项目执行单位37名工作人员进行小组讨论和个人深度访谈.结果 深圳市项目办、区项目办、项目执行单位存在纵向管理机制,并在孕产妇随访过程中存在纵向协作关系.疾控、妇保系统及市三院在项目培训、督导、孕产期综合干预、信息系统管理以及抗病毒治疗方面存在横向协作关系.截至到2010年底,已累计筛查177万孕产妇,HIV抗体检测率达96.2%.孕妇及产妇所生婴儿抗病毒药物服用率为92.2%和91.3%,婴儿早期诊断率为74.3%.结论 深圳市、区项目执行单位间纵向和多部门间横向分工协作的机制,能够使多种公共卫生资源高效整合和运作.