法律体系对京沪妇女保健保障程度
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摘要
目的评价京沪两地法律体系对妇女保健的保障程度及其与孕产妇死亡率的关系,验证适宜的法律保障程度的定位及其于京沪的意义。方法系统收集两地所有妇女保健相关的规范性法律文件,综合法律体系完备程度、法律地位保障程度、刚性约束程度以及主动完善相关法律的程度,量化计算法律体系的保障程度,并使用Spearman秩相关和线性回归模型分析法律体系的保障程度与孕产妇死亡率的关系。结果京沪两地妇女保健的法律体系保障程度均呈现逐步上升的趋势,北京由1990年的30.2%上升至2017年的69.8%,上海由1990年的43.5%上升至2017年的70.6%。两地的妇保法律体系保障程度与孕产妇死亡率均呈负相关(相关系数均大于0.75)。拟合回归方程显示,京沪法律体系保障程度对孕产妇死亡率变化的解释程度分别为57.5%和82.8%。结论完备的法律体系对引领、规范妇女保健体系的运行与发展的作用不可替代。两地已逐步形成较为完善的法律体系,但在法律的刚性约束程度方面均需要进一步加强。
Objective To evaluate the guarantee of legal regulations on maternal health care system and its correlation with maternal mortality of Beijing and Shanghai city and to verify appropriate legal guarantee on maternal health care system and its significance. Methods We systematically collected all normative legal documents related to maternal health issued by governmental agencies of the two cities and quantitatively assessed guarantee degree of the legal regulations by weighting the completeness, the legal status-defined support, rigid constraints, and the self-improvement of the legal regulations.Spearman rank correlation and one-way linear regression were used to analyze the relationship between the extent of legal regulations ′ guarantee on maternal health care and maternal mortality in the two cities. Results The extent of legal regulations′ guarantee on maternal health care in Beijing and Shanghai showed a gradual yearly upward trend. From 1990 to2017, the proportion of the maternal health programs guaranteed by legal regulations increased from 30.2% to 69.8% in Beijing and from 43.5% to 70.6% in Shanghai and the proportion was inversely associated with the maternal mortality in both the cities, with the correlation coefficients of greater than 0.75. The results of fitted regression analysis demonstrated that57.5% and 82.8% of the variation in the maternal mortality for the women in Beijing and Shanghai could be interpreted by the extent of legal regulations′ guarantee on maternal health care. Conclusion A perfect legal system is irreplaceable in guiding and regulating the operation and development of a maternal health care system. A relatively complete legal system related to maternal healthcare has been established in Beijing and Shanghai but the system needs to be further strengthened in its rigid binding force of the legal regulations.
Objective To evaluate the guarantee of legal regulations on maternal health care system and its correlation with maternal mortality of Beijing and Shanghai city and to verify appropriate legal guarantee on maternal health care system and its significance. Methods We systematically collected all normative legal documents related to maternal health issued by governmental agencies of the two cities and quantitatively assessed guarantee degree of the legal regulations by weighting the completeness, the legal status-defined support, rigid constraints, and the self-improvement of the legal regulations.Spearman rank correlation and one-way linear regression were used to analyze the relationship between the extent of legal regulations ′ guarantee on maternal health care and maternal mortality in the two cities. Results The extent of legal regulations′ guarantee on maternal health care in Beijing and Shanghai showed a gradual yearly upward trend. From 1990 to2017, the proportion of the maternal health programs guaranteed by legal regulations increased from 30.2% to 69.8% in Beijing and from 43.5% to 70.6% in Shanghai and the proportion was inversely associated with the maternal mortality in both the cities, with the correlation coefficients of greater than 0.75. The results of fitted regression analysis demonstrated that57.5% and 82.8% of the variation in the maternal mortality for the women in Beijing and Shanghai could be interpreted by the extent of legal regulations′ guarantee on maternal health care. Conclusion A perfect legal system is irreplaceable in guiding and regulating the operation and development of a maternal health care system. A relatively complete legal system related to maternal healthcare has been established in Beijing and Shanghai but the system needs to be further strengthened in its rigid binding force of the legal regulations.
引文
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[2]徐缓.美国州公共卫生法律示范项目对我国立法启示[J].中国公共卫生, 2007, 23(5):637–638.
[3]北京市卫生计生委.市卫计委2017年统计资料发布计划[EB/OL].[2017–01–19].http://tjj.beijing.gov.cn/tjsj/qtbmfbjh/201701/t20170119_367253.html.
[4]上海市卫生健康委员会. 2017年上海市卫生计生数据[EB/OL].[2018–05–15].http://www.wsjsw.gov.cn/tjsj2/20180815/58393.html.
[5]上海市人民政府.上海市计划生育条例实施细则[EB/OL].[1990–10–11].https://baike.baidu.com/item/%E4%B8%8A%E6%B5%B7%E5%B8%82%E8%AE%A1%E5%88%92%E7%94%9F%E8%82%B2%E6%9D%A1%E4%BE%8B%E5%AE%9E%E6%96%BD%E7%BB%86%E5%88%99/16541401.
[6]上海市人口和计划生育委员会.2002上海人口与计划生育年鉴[M].上海:科学技术文献出版社, 2002:86.
[7]汪建荣.卫生法[M].北京:人民卫生出版社, 2013:8–9.
[8]桑隆成,郑莹,史济德,等.上海市公共卫生法规体系现状调查分析[J].中国公共卫生管理, 1995(3):22–25.
[9]Ellencweig AY. Analyzing health systems:a modular approach[M].London:Oxford University Press, 1992.
[10]孙静,金平阅,张春瑜,等.卫生立法的国际经验对我国的启示[J].中国卫生政策研究, 2016, 9(10):66–71.
[11]蒋敏娟.法治视野下的政府跨部门协同机制探析[J].中国行政管理, 2015(8):37–41.