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农民工生殖健康需求和服务对策研究
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摘要
研究目的
     通过对农民工生殖健康需求和入住地相关服务基本信息的研究,为建立农民工生殖健康服务对策和流入地的属地化管理提供科学依据。
     研究方法
     通过不同城市农民工生殖健康调查所获得的基础资料,用EpiData 2.0,Excel2003,SPSS等软件进行数据处理,采用文献分析、描述性统计、单因素分析和决策树等方法对农民工的生殖健康需求和服务进行定量分析,然后运用健康教育、社会性别及健康人口学等理论进行剖析研究
     研究结果
     1、武汉、重庆和广州三市横断面调查发现,农民工生殖健康需求及服务存在以下问题:①生殖健康知识匮乏;②自我保健意识薄弱;③接受基本卫生服务和生殖健康服务主动性很差;④采取避孕节育措施的自主性较差;⑤对艾滋病和性传播疾病认知不足;⑥传统的性道德观念正在悄然发生改变,婚前性行为增多;⑦农民工入住地的生殖健康服务可及性较差。
     2对广州市农民工生殖健康需求及服务的进一步深入研究结果发现:①农民工生殖健康知识、行为及需求有明显的性别差异,如婚前性行为男性比例为43%,女性仅为12%;男性多性伴侣比例为23%,女性仅为11%。②社会人口学因素、流动性因素以及对生殖健康的认知因素,相互交融地对农民工生殖健康知识、态度和行为产生影响;社会人口学因素中,农民工的文化程度、年龄、结婚年龄与生殖健康认知、态度和行为关系密切,其中,认知与农民工生殖健康行为的相关性更为紧密。如从不使用安全套的比例,在知道安全套能避孕的未婚女性中为27.8%,而在不知道安全套能避孕的未婚女性中则为42%;③农民工得到的避孕药具提供、性病艾滋病查治以及相关的健康教育服务,在同一城市的不同社区差别较大,如开发区和番禺区的未婚男性获得避孕药具的比例达42.6%,而海珠区只有13.8%。
     3、武汉市已婚女性农民工健康教育干预试验表明,短期的健康教育能够迅速提高其生殖健康知识,但对专业性较强的知识效果不明显。
     研究特色:
     1、通过武汉、重庆、广州三市和广州这一具有农民工特色城市的生殖健康需求和服务研究,为全国深入了解农民工生殖健康现状提供了基础资料。
     2、从社会性别视角对广州市农民工生殖健康的分析研究,为全国今后制定城市农民工生殖健康评价体系奠定了基础。
Objective
     With the study on the needs and services of reproductive health of migrant workers in inflowing places, to provide the scientic data and facts for the establishment of strategies of the reproductive health services providing.
     Methods
     Under the foundation of KAP, Health demology and Gender theories, to study the reproductive health of migrant workers by qualitative analyse of the data from the cross-secectional surveys in different cities with the means of literature reviews, discriptive statistic, single factors analyzing and decision tree using Epidata2.0 Excel2003, SPSS13.0 softwares, etc.
     Results
     1. It’s found from the cross-sectional survey in Wuhan,Chongqin and Guangzhou cities that: (1)The knowledge of reproductive health in migrant workers is short; (2) The self-care in them is poor; (3) Getting reproductive health services on themselve’s own is not enough; (4) Using the contraceptive independent is poor; (5) The cognition of HIV/AIDS is not enough; (6) The traditional belief of sex on moral changed gadually and the premarital sex behaviors increased; (7) The reproductive health services on inflowing places is not accessibility enough.
     2. It’s found from the qualitative analyse of the data from the second cross-sectional survey in Guangzhou city that: In migrant workers, (1) there are lots of gender difference of reproductive health knowledges, behaviors ,needs and services, for instance, the percent premarital sex behaviors is 43% in males, but 12% in females, and the percent of multi-partners is 23% in males, but 11% in females; (2) The factors of socio-demology, floating and cognition affected the attitudes and behaviors of reproductive health interactionally in them.The effect of districts, educational levels, age and marrige time in socio-demology factors is obviously. The cognition of reproductive health with the behaviors is more close, for instance, the percent of never using condom in the unmarried females who know that condom can contracept is 27.8%, but 42% in those who don’t know that; (3) The provided services of reproductive health are different in different districts of the city, for instance, the percent of receiving contraceptive in unmarried males of Kaifa and Panyu districts is 42.6%, but 13.8% in Haizhu district.
     3. The intervention of reproductive health education in married females of Wuhan city show that the short-term health education could improve the general knoweledge of reroductive health , but not the proffessional.
     Conclusions
     1. The sicio-demology characteristics of migrant workers in different cities: the age of them is between 16-49 age; the main educational level is junior high school; the income is low generally; the inhibitant circumstance is poor.
     2. Lack of knowledge, poor self-care of reproductive health and changed traditional belief of sex on moral, the premarital sex behaviors increased, the risk of abortion and STD/HIV/AIDS spreeding increasing.
     3. The provided services of reproductive health in different inflowing place are different though a series of relevent policies were constituted.
     4. It’s suggested that the government should strengthen the responsibility and increase input for increasing the self-care ability of reproductive health in migrant workers, establishing and improving the system of management and services for them, in order to insure the sustainable development of reproductive health manage and services providing for migrant workers in cities.
     Innovation
     1. The basic information were provided for understanding the national conditions of reproductive health in migrant workers by the surveys of reproductive health in Wuhan, Chongqin and Guangzhou cities.
     2. The analyse of reproductive health of Guangzhou migrant workers on the Gender theories founded the basis for the establishment of reproductive health assesment system at national level in future.
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