目的：：总结江苏省4县为控制剖宫产率采取的政策与经济措施，并分析其成效，为控制剖宫产率提供可推广的经验方法。方法：对2009—2013年江苏省4县的住院自然分娩人数和剖宫产病例进行分析，比较剖宫产率的变化情况、孕产妇和新生儿死亡情况、剖宫产指征变化情况。结果：5年间4县平均剖宫产率呈逐年下降趋势，从2009年的60．2%下降至2013年的48．1%。结论：干预措施有效，但发挥作用有限，应加强社会各方对干预措施的重视程度，建立监督考评机制，规范接产医院医疗行为，加强助产技术培训，在政府部门配合下进行干预措施的推广。%Objective:To explore the propagable experience and methods of controlling the rate of cesarean sec-tion through the summary of the innovative measures in four counties. Methods:The cases of natural birth and cesare-an section from 2009 to 2013 in four counties were analyzed respectively. The interventions of controlling cesarean section rate have been summarized. Results:The average cesarean section rate of four counties in five years is on the decline, since 2009 the rate were 60. 2%,62. 3%,59. 3%,51. 4%,48. 1%. Conclusions: The interventions really worked, but did not do the best. Improving the social attention on these innovative measures, strengthening surveil-lance mechanism, regulating the medical behaviors of delivery hospitals, enhancing the midwifery training and promo-ting the interventions under the coordination of local government can further reduce the rate of cesarean section.
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