NCHIEN cuu KHOA HOC
THUC TRANG CHAM SOC SUC KHOE BA ME TRE EM, sue KHOE SINH SAN/KE HOACH HOA GIA DINH TAI MOT SO XA DAO CUA TINH QUANG NINH, QUANG NGAI, KIEN GIANG VA THANH PHO HO CHJ MINH
Phqm Hong Q u d n ' , Ld V a n Bdo^ D 6 Thanh Binh^
TOM TAT
Nghien ciiu md td cat ngang dugc thuc hien tai 12 xd ddo thugc 4 huyen ddo la Cd Td, Ly San, Can Gia vd Phu Qudc. Ket qua nghien cim eho thay; Cdng tac cham sdc sue khde bd me tre em, siic khde sinh sdn/ke hoach hda gia dinh tai cac xa ddo edn gap nhieu khd khan nhu: Ty Ie nao phd thai tucmg ddi cao, ty le phy nu: mang thai udng Vitamin A va vien sat cdn thap, nhieu tre de ra khdng dat tieu chuan ve can nang, mdt sd trudng hgp thai chet luu, nhieu xa dao khdng dat ty le 100%) tre em dudi 1 tudi khi sinh ra dugc tiem vacxin... Dd chinh la nhiing thdch thiic ddi hdi chiing ta can phai cd nhirng giai phap cu the de nang cao han nira chat lugng cdng tdc cham sdc siie khde ba me tre em, siic khde sinh sdn/ke hoach hda gia dinh.
Tu khoa: Cham sdc sire khoe, ba me tre em, sire khoe sinh sdn, ke hoach hod gia dinh, Qudng Ninh, Quang Ngai, Kien Giang, thanh phd Hd Chi Minh.
SUMMARY
Cross-sectional descriptive study was carried out in 12 villages of the island is the Island District 4 Co, Ly Son, Phu Quoc and Gio, The research results show that: The health care mothers and children, reproductive health/family planning in the island commune was diffi-
cult as: Percentage of aborrions relatively high propor- tion pregnant women vitamin a and iron is low, multiple births are not standard weight, some eases of stillbirth, many island commune not reach 100%i of children under 1 year of age at birth vaccinated...that is the challenge requires that we need to have specific measures to further improve the quality of care for matemal and child health, reproductive health/planning family.
Key words: Health care, reproductive health, fami- ly planing, mother - children, Quang Ninh, Quang Ngai, Kien Giang, Ho Chi Minh City.
I. DAT VAN DE
Khu vuc vung sau, vung xa, ndi cao, hai ddo cd ddn sd chiem khoang 62,4% ddn sd todn qudc; trong dd ty le dan sd nii 15-49 tudi la 47,9%. trong tdng sd nii ciia khu vuc (ty le nay chung ca nudc la 51%.) [5]; khodng 12,3%.
phu nii d viing sau, vimg xa chua tung duge bao gia di hpc, ly le nay cao gdp gan 3 lan so vdi sd lieu chung ciia toan qudc; ty Ie phu nii chua tdt nghiep ti6u hpc Id 30,3%.
[4]. Dan sd vd chdt lugng cham sdc ciia ddng bao cac tinh khu vuc viing sau, viing xa, mil cao, hdi ddo ludn la vdn de dugc Dang va Nhd nudc dae biet quan tdm. Trong
1. Tong Cue ddn s6 2. Hoc vi@n Quan y
^> Ngay nhan bai: 26/02/2015 I » Ngay phdn bien: 29/02/2015 j » Ngay duyet dang: 01/03/2015
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nhiing nam gdn ddy, cdng tde cham sdc SKBMTE, KHHGD tuy da d^t dugc nhiing kh gud dang khich le, song van cdn rdt nhieu ban ehe, nhat la d cdc vung sau, viing xa, mii cao, hdi dao. Theo Bdo cdo kit qud dipu tra bidn dpng dan sd vd KHHGD nam 2010 cua Tdng cue Thdng ke, d khu vuc vung sdu, vung xa, niii eao, hdi dao cd ty sudt sinh thd vdo khodng 2,01%», trong khi tinh ehung cho toan qudc la 1,68%), ty Ie sinh con thii 3 trd len Id 24,2%; ty sudt chdt so sinh la 1,43%; ty sudt chk tho la 0,44%); ty le hut dilu hda kinh nguy?t Id 0,54%o va ty le nao phd thai an toan la 1,03%.. Cdc ty le ndy deu cao hgn so vdi ty le ehung cua toan qudc [6].
Hieu bigt yg cdc bien phap KHHGD ciia phu nii la mdt trong nhiing dieu kien tien quyet dat muc tiSu ve gidm mirc sinh. Ciing theo ket qua dieu tra cua Tdng cyc Thdng ke nam 2010, tren 97%) ddi tugng vung sdu, viing xa, hai dao cd hieu biet ve mdt bien phdp trdnh thai bdt ky. Ty le cdc cap vg chdng trong dp tudi sinh de su dung bien phdp trdnh thai la 84,9%i. Trong dd, bien phap tranh thai hien dai la 64,7%.. Bien phdp hien dai dugc sii dyng chu yeu Id dat dung cu tir cung (53,2%)), triet san nu (8,6%), thuoc vien uong trdnh thai (5,5%) va BCS (7,9%)). Ngudn cung cap cac bien phap tranh thai chu yeu Id tai cdc ca sd y te (95,1%.), ty le nay cao ban so vdi cd nude (89,3%)). Ddy eung la dieu tdt yeu khi he thdng y te tu nhan chua phat trien d vung sau, viing xa, hai dao [4].
Mac dii d nudc ta, he thdng chdm sdc SKBMTE/
KHHGD da dugc phdt trien rdng khap trong toan qudc, d tat ca cac tuyen y te tinh, huyen, xa. Tuy nhien III. KET QUA NGHlfiN ClTU
Bdng 1. Tinh hinh thuc hipn mot so chi tiiu chdm
a khu vuc vung sau, viing xa, hdi dao do dieu kien kinh tS cdn ngheo nan, giao thdng di lai khd khan, mang ludi dich vy eham sdc SKBMTE chua hodn thi?n nen phdn nao vdn chua dap ling dupe nhu cau cua ddng bao cdc dan tpc trong eham sdc SKBMTE/KHHGD. Thuc t8 cho thay, d viing sau, vung xa, hdi ddo cd khoang 20,3%. cac trudng hpp sinh md ngudi m? khdng di kham thai ldn nao, sd eac trudng hpp sinh dugc kham thai bdi bdc sy chi chiem khoang 27,7%o va 45,7% dugc khdm bdi y sy, y td, nii hg sinh da duge qua dao t^o. Tinh chung toan qudc, sd ba me khdng di kham thai ehi cd 11,1%, so cac trudng hgp duge khdm thai bdi bae sy la 17,6% vd dugc kham bdi y sy, y td, nii hg sinh da dugc qua dao tao la 50,6% [3].
n. DOI TirONG VA PHlTOfNG PHAP NGHIEN CUtJ.
- Dia diem nghien cim: Tai 3 huyen ddo vd 1 huyen ddo cd xa ddo: Cd Td, Ly San, Can Gid va Phu Qudc.
- Thai gian nghien ciiu: Tii thdng 10/2013 den thdng 12/2013.
- Ddi tupng nghien eiiu: La ngudi dupc sir dung dich vu cham sdc SKBMTE/KHHGD- Phu nii dang mang thai, phu nu cd con dudi 5 tudi.
- Phuang phdp nghien ciru: Ap dyng thiet ke nghien ciiu md td cat ngang.
- Ky thuat thu thap sd lieu: Thu thdp vd phdn tich so Heu thii cap tu cdc bdo cao tdng ket ve cdng tae cham sde SKBMTE/KHHGD dia phuang, don vi thupc dia ban nghien eiiu.
sdc sue khde bd me trong thai ky mang thai (%)
Huyfn d i o
Co To
Son Can Gia Phu Quoc
Xadio
TT Co To Thanh Lan Dong Ti6n An Bmh An Hal An Vinh TT Can Thach Long Hoa Thach An Ganh Dau Ham Ninh BaiThom
Ty
pha thai 25,6 3,0 7,5 23,4 4,4 10,2 5,5 7,6 17,7 37,8 3,5 3,2
Tyle khdm thai
97,7 100,0 95,8 95,5 100,0 100,0 98,8 99,2 100,0 97,0 100,0 92,2
T y l f uSng vitamin
A 90,8 98,6 95,4 90,6 100,0 100,0 85.5 77.7 99,6 51,3 100,0 93,0
Tyl?
u^ng vien s^t 98,1 97,1 70,3 88,7 100,0 100,0 74,7 87,6 97,8 100,0 100,0 100,0
Tyle tang trpng liTffng dii can 90,7 99,2 95,8 79,6 98,7 80,3 77,8 80,5 85,4 100,0 100,0 66,9
Ty H phu nir mang thai mic bfnh
50,2 98,8 77,7 88,5 98,6 20,7 70,3 85,3 71,2 27,2 32,5 12,0
T y l j de tai tram
y t e 0 35,5
0 0 0 0 0 0 0 13,4 6,7 9,8
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NGHIEN CUU KHOA HOC
Ty le nao phd thai cua phy nii tai cdc xa dao tuang ddi eao, trong dd cao nhat la xa Gdnh Dau (37,8%), thip nhdt Id xa Thanh Ldn (3,0%). Ve ty le kham thai, chi cd 5/12 xa ddo 100% phu nir mang thai dugc khdm thai. 3/12 xd ddo 100% thai phu khi mang thai duge udng vitamin A. Ty le phu nii tang trgng du can tai cdc xa dao dao dgng tir 66,9%
d6n 100%). Trong khi dd ty le phy nH mang thai mac benh dao dgng tir 12,0% den 98,8%i. Cd 4/12 xa dao phu nu co sinh con tai tram y te, trong dd cao nhat la xa Thanh Lan (35,5%).
Bdng 2. Tinh hinh thgrc hien mpt so chi tieu chdm sdc sue khde bd me trong thdi ky sau de tgi cac xa ddo (%)
Huyen dao
CO To Ly Son Can Gift Phu Quoc
Xa dao
T T C 6 T 6 Thanh Lan Dong Tien An Binh An Hai An Vinh TT Can Thach Long Hoa Thach An Ganh Dau Ham Ninh Bai Tham
Tyle dirtrc cham soc
biyi CBYT
100 100 100 77,9 100 100 100 100 87,8 69,7 71,8 48,6
TylS dirtfc u6ng vien sSt
80,4 90,3 90 65,7 100 100 61,2 70,2 55,3 66,0 90,2 15,6
T y l j dir^c u6ng vitamin
A 70,5 80,1 100 84,4 100 100 70,5 33,4 40,4 13,6 91,3 29,8
T y l j mac 5 tai bien san khoa
0 0 0 0 0 0 0 0 0 0 0 0
Ty,lj m^c bjnh khi nudi con 65,2 34,4 22,1 15,6 3,2 2,3 10,7 15,3 11,3 12,0 9,2 3,6
Ty suat ch^t mf 0 0 0 0 0 0 0 0 0 0 0 0
Ket qua nghien ciiu eho thay, 7/12 xa ddo 100% phu nu sau de dugc cdn bd y tk eham sdc, thdp nhdt Id xa Bai Tham (48,6%). Ty le dugc udng vien sk cua phu nii sau de tai cdc xa ddo ciing khdng ddng ddu nhau. Cao nhdt la 100%. (xa An Hai va An Vinh), thdp nhat Id 15,6% (xa Bai Tham). Ty Ie udng vitamin A sau de ctia phu nii cung tuong tu nhu ty le udng vien sdt: cao nhdt 100% (xa An Hdi vd An VTnh), thdp nhdt la xa Gdnh Ddu (13,6%). Ty le mdc benh khi nudi eon cua phu nii ciing dao ddng trong khodng 2,3%t (xa An VTnh) din 65,2%. (thi trdn Cd Td).
Bdng 3. Tinh hinh thu'c hien mpt sd chi tiiu khdm bpnh tgi cdc xd ddo Huyjn
Co To Ly Son Can Gift
Phli Quoc
Xa dao T T C 6 T 6 Xa Thanh Lan Xa Dong Tien Xii An Binh An Hai An VTnh TT Can Thach Xa Long Hoa Xa Thach An Xa Ganh Dau Xa Ham Ninh Xa Bai Tham
Sfi \vfft pby nir chung diro-c kham b jnb
420 270 450 170 1.067 1.500 560 815 325 390 1.862 1.536
So linyt phv nir 1 5 ^ 9 tuoi dircc kham benh
280 140 300 156 765 700 470 668 280 312 1.462 1.020
Trong nam 2012, cac xa dao nghien ciiu da kham benh cho 9.365 lugt phu nii, dat trung binh 780, 4 phu nu/xa ddo, xa ddo khdm nhiiu nhdt la xa Hdm Ninh (1.862), it nhdt la xa An Binh (170) Sd phy nii tir 15 d6n 49 tudi dupc kham benh dao dgng tii 140 (xa Thanh Ldn) den 1.462 (xa Ham Ninh).
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Bang 4. Tinh hinh thuc hipn mpt so chi tiiu cham sdc sire khde tre sff sinh (%)
Huyen dao
Co To
Son Can Gicr Phu Quoc
Xadao
T T C 6 T 6 Thanh Lan Dong Tien An Binh An Hai An VTnh TT Can Thach Long Hoa Tliach An Ganh Dau HamNutb BaiThom
Tylf thai ch^t lira 2,1 0 0 0 0 0 0 0 0 0 0 0
Tyl?
tre nh$
cSn 0 0,1
0 0 0 2.4 5,3 4,3 7,9 3,4 2,1 3,9
Tyl?
tre bj di tat bam sinh
0 0 0 0 0 0 0 0 0 0 0 0
Ty le tre dirgrc bii ngay gl*
dau sau de 81,3 89,1 88,3 91,4 75,6 91,1 78,6 74,3 75,5 83,5 91.8 86.6
Ty le tre bi nhilm triing ron/uon van ron 0 0 0 0 0 0 0 0 0 0 0 0
Ty Ij tre tiem AT dii theo quy djnh 95.5 99.0 97.2 96.4 95.3 100.0
80,2 84,3 86,6 97,7 100,0 93,4
Thi trdn Cd Td ty le thai chet luu chiem tdi 2,1%. Xa ddo cd ty letrederanhe cdn cao nhdt la Thach An (7,9%).
2/12 xa ddo 100% tre sa sinh dugc tiem AT dii theo quy dinh, thdp nhat Id thi trdn Cdn Thach (80,2%). Cac xa ddo nghien ciiu khdng co trudng hgp ndo tre de ra bi di tdt bdm sinh, nhiem triing rdn.
Bdng 5. Tinh hinh thuc hien mat sd chi tiiu chdm sdc sire khoe tre em (%)
Huyen dao Co To Ly Son Cin Gia Phu Quoc
Xadao TT Co To Thanh Lan Dong Tien An Binh An Hai An VTnh TT Can Thach Long Hoa Thach An Ganh Dau Ham Ninh Bai Thorn
Ty le tre dirdi 1 tuSi diroc tiem vacsin di]
lieu 100.0 100,0 97,3 96,9 100.0 98,4 96.4 98,2 99,2 97,4 99,3 100,0
Tyle dirdll tuoi bj
SDD 11,2 17,4 14,7 18,7 16,6 20,4 10,2 7,3 20,3 6,3 5.7 15.5
Ty le tre diroi 5 tuoi hi viem diromg ho hap
80.5 30.3 35.4 65,6 77,7 15.5 92,7 80,5 84.6 87.7 70,6 77,7
Ty suat chet tre em duifi
1 tuoi 0 0 0 0 0 0.1 0 0 0 0 0 0
Ty suat chet tre emdiroi 5 tuoi 0 0 0 0 0 0,2 0 0 0 0 0 0
8/12 xa dao khdng dat ty le 100% tre em dudi 1 tudi dugc tiem vacxin du Hdu. Xd dao cd ty le tre em dudi I tudi dugc tiem vacxin dii lieu thap nhat la thi trdn Cdn Thach (96,4%). Ty le tre bi suy dinh dudng d cdc xa ddo cung tucmg ddi cao. Thdp nhdt Id xa Ham Ninh (5,7%), cao nhdt la xa An VTnh (20,4%). Ty le tre dudi 5 tudi vi viem dudng hd hdp dao ddng tir 15,5% din 92,7%. An Vinh Id xa ddo duy nhat cd tre em chdt dudi 1 tudi va 5 tudi (ty suat tucmg ling la 0,1% va 0,2%).
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£
^ NGHIEN cuu KHOA HOC
3dng 6.
Huyfn dHo
Co To Ly Son C4n Gio Phu Quoc
Tinh hinh thfrc hi^n mpt so chi tieu ve truyen thdng chdm soc
X a d a o
TTC6T6 Thanh Lan Dong Tien An Binh An Hai An VTnh TT can Thach Long Hoa Thach An Ganh Dau Ham Ninh Bai Thom
Si loa dai c8ng cOng hoat 2 1 2 1 1 2 6 5 2 5 1 1
So sach da phiit
43 150
30 45 125 20 46 20 45 50 36 300
So tor roi da phat
1 540 1.000 1.000 300 320 1.500 3.000 2.000 1.700 1.500 1.500 1.500
Si kh^u hl^u, Sp phich
da diing
16 8 25 10 35 9 2 8 12 20 8 10
S6 buoi truyen
thong da thirc hi§n 12 7 12 10 6 10 24 28 20 24 43 24
T J l i phu nir dirp'c
tir vln 85.2 90,7 70,1 80.5 77.4 81.2 87.6 76.9 86.3 80,9 82.2 70,2
SKSS/KHHGB T y l f nam gioi dir^'c nghe tir van 65.4 50.1 53.3 70.7 48.0 35.7 79,3 55,5 45,2 70,9 83,4 80,5
Tylf cdn bfi V T d i truyin thong cdc loai 95.3 99.7 100.0 95,4 100.0 100.0 100.0 96.7 97.7 100.0 100,0 100.0
Sd loa ddi truyen thdng cdng cdng phuc vu cdng tdc cham sdc SKSS/KHHGD tai cdc xa ddo dao ddng tir 1 den 6- Sd sach da phat cao nhat Id tai xa Bai Tham, thap nhat Id xa An VTnh, sd td rai da phat cao nhdt Id thi trdn Can Thach (3.000 td), thap nhat la xa An Binh (300 td) Sd khau hieu dp phich da diing nhieu nhdt la tai xa An Hai (35), thdp nhdt la thi tran Can Thach (2). Sd budi truyen thdng da thuc hien nhieu nhdt Id 28 budi (xa Long Hda), it nhat lad budi (xa An Hdi). Ty le phu nij dugc tu van cao nhdt Id 90,7% (xa Thanh Ldn), it nhat la 70,1%. (xa Ddng Tien).
Ty Ie nam gidi dugc nghe tu vdn cao nhdt Id 83,4% (xd Ham Ninh), ty le thdp nhdt la 35,7% (xa An Vinh). 6/12 xa ddo 100% can bd y te da tham gia truyen thdng cdc loai ve cham sdc sire khde bd me tre em, ke hoach hda gia dinh.
Bdng 7. Tinh hinh thiyc hipn mpt sd chi tieu vi KHHGD (%)
Huyen dao
Co To Ly Son can Gio Phu Quoc
Xa dao
TTCoTo Thanh Liin Dong Tien An Binh An Hal An VTnh TT Can Thach Long Hoa Thach An Ganh Dan Ham Ninh Bai Therm
Ty 1? phi^ nir c6 chong SIT
dung bien phdp tranh
thai 80.1 85.4 85.7 78.7 53.2 88.8 85.0 77.7 79.3 70.5 80.2 85.3
Ty If phu nir CO chong sir dung vong tranh thai 25.5 30.2 60.4 41.6 15,8 61.7 65.0 33.5 22.3 35.2 41,1 46,2
Ty If phij nir CO chong sir dung thuoc trdnh thai
38.7 40,4 10.5 20.1 13.2 15.3 15,0 14.3 40,6 20,1 16,7 16,8
Ty If phu nil CO chong sir dung bifn phdp trdnh thai khde
15,9 14.8 14.8 17,0 24.2 11.8 5,0 29.9 16.4 15,2 23,4 22,3
Ty Ie phu nii cd chdng tai cdc xa ddo sii dung bien phap trdnh thai tuang ddi cao, trong dd cao nhdt Id xd An VTnh (88,8%), tilp dgn Id xa Ddng Ti8n (85,7%), xa Bai Tham (85,3%)... Ty le phu nii cd chdng su dung vdng tranh thai dao ddng tii 15,8% den 65,0%. Ty le phu nu cd chdng sii dung thudc tranh thai dao dgng tii 13,2% dSn 40,6% vd ty le phu nir cd chdng sir dung bien phap trdnh thai khac dao ddng tir 5,0% dkn 29,9%..
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IV. BAN LUAN
Thuc trsmg cdng tdc cham sdc siic khde bd m? cho thdy, ty le nao phd thai ciia phu nii trong nam 2012 tai cdc xa dao tuang ddi cao, trong dd cao nhdt la xa Gdnh Ddu (77,8%).
Tai cdc xa dao theo dieu tra cua chiing tdi mgt trong nhiing nguyen nhdn ddn din tinh trang tren Id do vi thanh nien thilu thong tin ve siic khde sinh sdn, sire khde tinh due ciing nhu thieu ngudi cung cap thdng tin ve chu de nay. Ngodi ra, cdc bac cha me gia dinh va xa hdi thudng e ngai ne tranh khi de cap den chii dk ndy, ddc biet la h? thdng dich vu thdn thien vdi vi thanh nien cdn qud mdng.
Ket qua ciia nghien cihi nay cho thdy, chi cd 4 tram y te xa cd phu nii sinh con tai tram, ty le sinh con tai tram ngay cdng cd xu hudng gidm ddn trong nhirng nam gdn ddy. Ly do dugc nhilu can bg y te cho biet tram y tl xa dao chi tien gdn nha nhung lai khdng cd bdc sy chuyen vl san khoa, trong khi dd benh vien khdng nhirng ddy dii trang hi, may mdc md y bac sy cdn cd trinh do chuyen mdn sdu, de ddng ling phd vdi cac tinh hudng xdy ra khi sinh.
Trong cd nam 2012 khdng cd trudng hop phu nir nao mac 5 tai bien sdn khoa ciing nhu khdng cd ca chet me nao dugc ghi nhJin. Viec khdng cd ca tai bien sdn khoa nao tai 12 xa ddo nghien ciiu thdp hon rdt nhieu so vdi ty le dua ra ciia Td chiic Y te the gidi khdng phai do khdng cd tai bien san khoa rad do cdc ca de khi cd tien lugng tai bien da dugc chuyen len tuyen tren. Mpt ly do khac la mgt sd xa do chua du dieu kien ve ca sd ha tdng, trang thiet bi cung nhu chuyen mdn nen khdng duoc tien hdnh cac thii thudt nao hut thai ciing nhu cac thu thudt ien quan den san khoa.
Ket qua nghien ciiu ciia chiinp tdi chi ghi nhan duy nhat An VTnh la xa ddo cd tre em chet dudi 1 tudi vd 5 tudi (ty sudt tuong ling Id 0,1 %i vd 0,2%). Ty sudt tu vong tre em
dudi 5 tudi ciia nghien ciiu nay thdp han rat nhilu nghien ciiu ciia Dang Xuan Nguyen vd CS vd Dinh Van Thiic khi nghien cim ty le tii vong cua tre em dudi 5 tudi tai 10 xa buyen Thuy Nguyen, Hdi Phdng Id 18,06%.. Nguyen nhan ni vong la do chet dudi, de non va viem phdi.
Ket qua nghien ciiu cho thdy ty I? phu nii cd chdng sii dung vdng trdnh thai tai cac xa ddo nghien cihi cao hon so vdi cac bien phap tranh thai khac nhu thudc udng trdnh thai, thudc dem trdnh thai, bao cao su... Tdng hgp y kien thdo luan nhdm tai cdc xa dao, sd dl phu nii tai cac xd dao sir dung nhieu vdng tranh thai Id do cac bien phdp tranh thai khac CO nhieu nhugc diem nhu: Bao cao su hay 1dm gian doan hoat ddng tinh due, phdi ludn cd san tnrdc khi quan he tinh due. Thudc udng trdnh thai thi phdi udng hdng ngay vao gid nhdt dinh, nhieu tdc dung phu ddc biet Id ddi vdi he tim mach. Thudc tranh thai khan cap nhieu tac dung phu vd hieu qua tranh thai khdng cao. Hon nira, ty le phu nii d cac xa ddo mac benh phu khoa khdng cao nen chi em thudng chgn bien phap tranh thai la dat vdng. Ket qua nghien curu nay phii hgp vdi nghien cuu ciia Trdn Bich Hdi nghien ciiu tai huyen Vinh Bao, Hai Phdng.
V. KET LUAN
Ty le nao phd thai cao nhat tai cdc xa ddo Id 77,8%. Ty le udng Vitamin va vien sat ciia thai phu khd thap. 7/12 xa dao 100% phu nii dugc cdn bd y te chdm sdc sau de. Xa ddo cd ty ie thai chet luu cao nhat la 2,1 %. Khdng cd trudng hgp ndo tre de ra hi di tdt bdm sinh, nhiem trung rdn. Tai cdc xa ddo phuang tien truyen thdng ve cham sdc SKSS/KHHGD rdt phong phu. Ty le nam gioi dugc nghe tu vdn cao nhat dat 83,4%. Ty le phu nii co chdng sir dung bien phap tranh thai cao nhdt Id 88,8%, thdp nhdt Id 70,5%.
TAI LlgU THAM KHAO
1. Ban chu nhiem Chuang trinh y te sd 12 (1997), Danh gid kit qud thuc hien KHQDY ttong chiln luge cham sdc siic khde nhan dan vd bd ddi vung sau, vung xa, giai doan 1990 -1997, dinh hudng boat dgng giai doan 1998 -2000.
2. Ban chii nhiem Chuang trinh y te s6 12 (1997), Phat tnIn su nghiep KHQDY xay dung qudc phdng toan dan va cham sdc sue khde nhdn ddn, Bao cao tai hdi nghj KHQDY todn qudc ldn thii 2 thdng 7 nam 1995.
3. Nguyin Thi Lan (2004), Danh gid sir thay ddi kiln thiic, thdi do vd thuc hdnh ciia phu nii tudi sinh de vl dich vu chdm sdc SKBMTE/KHHGD d mgt sd xd huyen Ba Vi, tinh Ha Tdy, Ludn van thac sy y hgc, Hgc vien Qudn y.
4. Pham Ba Nhdt, Pham Van Thao (2004), "Mgt sd kit qud vl viec kit hgp Quan dan y - Dan so tai cdc xd khd khdn thugc dnh An Giang vd Kien Giang nam 2003", Tap chi Y dugc hgc Qudn su, sd 1 /2004.
5. Thu tudng Chinh phu (2007), Quylt djnh sd 108/2607/QD-TTg ngdy 17/7/2007 cua Thu tudng Chinh phii vl viec phe duyet chuang trinh muc tieu y tl Qudc gia, phdng chdng mdt sd benh xa hdi, benh dich nguy hilm vd HIV/AIDS giai doan 2006-2010.
6. Tong cue Dan s6 (2004, 2006), Dilu tra bien dgng dan sd va kl hoach hda gia dmh, Nxb Thdng ke. Ha Ndi.
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