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目的:了解和评价深圳市不同服务系统和不同等级医疗机构流产服务状况。方法:选择该市计划生育和卫生6家不同等级流产服务机构,采用现场观察和深入访谈等定性研究方法,了解相关设施设备、服务规范、服务记录状况以及流产服务提供过程,进行总结和评价。结果:各家机构设施设备良好,但部分机构手术室和观察室不能满足流产妇女隐私保护和舒适性需要。流产妇女基本能够知情后选择流产方法,但术前血常规和阴道分泌物检查存在一定的医患分歧。多数机构药物流产的有效性偏低(<91.7%),服务记录的内容和完整性尚有一定欠缺,医患交流不足,避孕服务缺乏积极主动。卫生机构流产妇女量经常超出其基础设施承受能力,技术人员相对不足,而计划生育机构流产妇女较少,服务资源利用不充分。结论:要加强机构管理者和技术人员流产优质服务的意识,特别要加强被服务者隐私保护和流产后计划生育服务。有必要积极探讨药物流产有效性偏低的原因,合理分流服务对象,提高计划生育机构流产服务资源利用率。
Objectives: To understand and evaluate abortion service status of different service systems and medical institutions in Shenzhen. Methods: Six different abortion service agencies of family planning and health care in the city were selected. Qualitative research methods such as on-site observation and in-depth interviews were used to understand the related facility equipment, service regulations, service records and abortion service delivery process, and to summarize and evaluate them. Results: The equipment and facilities in each institution were good, but the operating room and observation room of some institutions could not meet the privacy protection and comfort needs of abortion women. Abortion women can be informed of the basic choice of abortion method, but preoperative blood and vaginal secretions examination there is a certain doctor and patient differences. In most institutions, the effectiveness of medical abortion is low (<91.7%). There is still a certain lack of content and completeness of service records, lack of communication between doctors and patients, and lack of proactive contraception services. The number of aborting women in health facilities has often exceeded the affordability of their infrastructure, with relatively inadequate technical staff, while fewer women have abortions in family planning institutions and inadequate utilization of service resources. Conclusion: It is necessary to strengthen the awareness of institutional managers and technicians on abortion quality services, especially to strengthen the privacy protection of service personnel and post-abortion family planning services. It is necessary to actively explore the reasons for the low effectiveness of medical abortion, rational distribution of service targets, improve abortion services utilization rate of family planning institutions.