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首页> 外文期刊>Journal of Medical Sciences >Maternity and Child Health Care Services Delivered by Public Health Centers Compared to Health Cooperatives: Iran`s Experience
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Maternity and Child Health Care Services Delivered by Public Health Centers Compared to Health Cooperatives: Iran`s Experience

机译：公共卫生中心提供的妇幼保健服务与卫生合作社的比较：伊朗的经验

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Reform programs in some developing countries are focused in transferring these services to nongovernmental organizations or groups. In this WHO grant study our aim was to implement and evaluate the efficacy of a new model for transferring state service delivery governance to nongovernmental groups and studying if they can be efficient in field of child and maternity health services compared to public health centers. In this comparative study a total of 1000 households were selected systematically from the population covered by 9 health centers transferred to cooperatives and 18 current public health centers. Data were collected during a three months long study period and analyzed by SPSS 10 statistical package. Chi-Square and t-tests were used to analyze data. Overall health care coverage was higher for either cooperative or public health centers compared to private sector physicians (p = 0.005).Around 88.8% of under 6 years aged children were under coverage of health services provided by health centers in both groups and no difference was found. There was no statistically significant difference in quality of child health care services in declaring the date of health care visit and follow up in due time. There was no difference between the groups in perfect filling child growth cards but the ability of mothers in interpreting child growth cards was statistically higher for the population covered by cooperative health centers (p = 0.02). Growth status of children based on growth percentiles were relatively similar in two groups. Some health indices of target groups covered by public and cooperative health centers such as family planning, child health cares, perinatal cares, and the numbers of households covered by health volunteers were studied. The results showed that in all of these fields cooperative health centers had better rates. Observed differences were statistically significant (family planning: p = 0.03, infant health care: p = 0.03, 1-6 years old children cares: p = 0.009). The proportion of those women owning a vaccination record (card) was higher in population covered by cooperative health centers (p = 0.004). The rate for performing a cervical smear examination during the national program for cervical cancer screening was higher for the women covered by cooperative health centers (p = 0.01). No difference was found between the knowledge level of women covered by cooperative health centers about the importance of cervical examination when compared with public health centers. We conclude that in the field of target group children?s health care and maternity health services, cooperatives sector not only acts as well as public sector meeting the standards of the program, but also has got a better function in some areas. This can be assumed as an achievement for the policy of transferring the health services to cooperative health centers along with ongoing governmental supervision.
机译：一些发展中国家的改革方案的重点是将这些服务转移给非政府组织或团体。在世卫组织的这项赠款研究中，我们的目标是实施和评估将国家服务提供管理转移到非政府组织的新模型的有效性，并研究与公共卫生中心相比，它们在儿童和产妇保健服务领域是否有效。在这项比较研究中，从9个转移到合作社的卫生中心和18个当前的公共卫生中心系统地选择了1000户家庭。在为期三个月的研究期内收集了数据，并通过SPSS 10统计软件包进行了分析。卡方检验和t检验用于分析数据。与私营部门的医生相比，合作或公共卫生中心的总体卫生保健覆盖率更高（p = 0.005）。两组中约有88.8％的6岁以下儿童接受了由卫生中心提供的卫生服务覆盖，两组之间无差异找到了。在宣布就诊时间和随访时间方面，儿童保健服务质量在统计上没有显着差异。完美填满儿童生长卡的两组之间没有差异，但是对于合作医疗中心覆盖的人群，母亲解释儿童生长卡的能力在统计学上更高（p = 0.02）。两组儿童基于生长百分位数的生长状况相对相似。研究了公共和合作医疗中心覆盖的目标人群的一些健康指数，例如计划生育，儿童保健，围产期保健以及卫生志愿者覆盖的家庭数量。结果表明，在所有这些领域中，合作医疗中心的比率都更高。观察到的差异具有统计学意义（计划生育：p = 0.03，婴儿保健：p = 0.03，1-6岁儿童看护：p = 0.009）。在合作医疗中心覆盖的人口中，拥有疫苗接种记录（卡片）的妇女比例更高（p = 0.004）。合作医疗中心覆盖的妇女在国家宫颈癌筛查国家计划期间进行宫颈涂片检查的比例更高（p = 0.01）。与公共卫生中心相比，合作医疗中心所覆盖的妇女对子宫颈检查的重要性的知识水平没有差异。我们得出的结论是，在目标群体儿童的医疗保健和产妇保健服务领域，合作社部门不仅在达到该计划标准方面表现良好，而且在公共部门方面也表现出色，而且在某些领域也发挥了更好的作用。可以认为这是将卫生服务转移到合作医疗中心的政策以及正在进行的政府监督的一项成就。

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