Status quo analysis and countermeasures of maternal and child health services in Karamay City

Objective To understand the current situation of maternal and child health care services in karamay, analyze the advantages and disadvantages of service modes, and explore the countermeasures to solve the problems.Methods A combination of quantitative research and qualitative research was used. Through obstetric quality assessment, interviews with relevant maternal and child health experts, based on a baseline survey, qualitative analysis was conducted. The annual report on maternal and child health in the past five years was used to quantitatively analyzed. The indicators of maternal and child health services and health indicators were analyzed by EXCEL 2007 and SPSS 17. 0.Results ① The Karamay Maternal and Child Health Care Center is a department of the Municipal Center for Disease Control and Prevention that performs the functions of a municipal-level maternity and child care agency.Midwifery services rely on the obstetric departments of 4 general hospitals, and maternal and child health services are undertaken by the community health service centers (township health centers). ② There are 45 maternal and child health professional and technical personnel in all community health service centers in the city, accounting for 28. 48% of the total number of maternity and child care services personnel. Only one person has a senior professional title, accounting for 0. 63%. There are 17 professional workers with bachelor degree or above, accounting for 10. 76%. There are 29 professional workers aged over 40 years old, accounting for 64. 4%. ③ The number of pregnant women in the city, the antenatal examination rate, the times of antenatal examination ≥ 5 times, the rate of postpartum visit and the rate of hospital delivery have shown an upward trend in recent five years and maintained a relatively high level in the past five years. There were statistically significant differences among different years (P < 0. 01). The rate of early antenatal examination and the rate of systematic management were lower than the national average. The average cesarean section rate during the five years was 59. 77%, which was higher than the average level of the whole autonomous region and the whole country. The incidence of high-risk maternal ratios and macrosomia increased year by year. Five-year high-risk maternal women accounted for 33. 36% of the total number of pregnant women. The incidence of macrosomia has increased year by year. The average incidence of macrosomia in the five years was 13. 78%. There was a statistically significant difference between each year (P < 0. 01). In the past five years, the average maternal mortality rate was 26. 89 per 100 000, which was 6. 79 percentage points higher than the national average (20. 1/10 million). There was a upward trend in maternal mortality from 2013 to 2014, and there was a statistically significant difference in the overall mortality trend (P < 0. 05).Conclusion ① Karamay city's maternal and child health service system is not perfect and its institutions are imperfect. ② The city's maternity and child care management model is segmented and disassembled. There is a shortage of grass-roots personnel, especially is lack of senior personnel, and the service capacity is obviously insufficient. ③ The number of high-risk pregnant women has been increasing year by year, the incidence of macrosomia has been on an upward trend, and the rate of cesarean section has been ranked as the forefront of the whole autonomous in terms of prefectures. Recommend ① To establish and improve the construction of three levels of maternal and child health institutions in prefectures, counties, districts and townships (community health service centers). ② To form counterpart-assistance relationships between comprehensive hospitals and grass-roots community health service centers, and increase training efforts, and continuously improve grass-roots service capabilities and levels. ③ To utilize "Internet +, MCH Information Platform" to link community maternal and child health care with clinical firstline paediatric services to bridge the shortcomings of segmented management of maternity and child care in the city and establish a health care internet and seamless health in the Karamay region. To shift the barriers for the management of obstetrics risks.