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目的:调查浙江省宁波市鄞州区姜山社区医生督导下的流动儿童免疫规划现状,分析存在的原因和不足,对免疫规划效果进行评价。方法:自行设计调查问卷,对本辖区1800户有流动儿童的外来工家庭入户进行现场问卷调查,社区医生通过入户随访、接种证查验、健康教育、预防接种告知书发放、利用手机微信建立流动人口微信群等多种途径,督导流动儿童完成各阶段的免疫规划任务。结果:根据问卷调查结果,社区医生督导下流动儿童的预防接种证建证率,政府出资、免费接种一类疫苗全程接种率与2012年比较,有了明显的提高。2013年底流动儿童免疫规划合格接种率基本达到了国家免疫规划实施方案的规定要求。2013年水痘发病率为5.34%,麻疹发病率为0.64‰,比2012年流动儿童的相关疾病发病率降低。流动人口对社区医院预防接种服务满意度普遍提高,达到了95.20%以上。结论:社区医院承办、社区医生主体督导的流动儿童免疫规划管理模式,对有效落实免疫规划进行了有益探索和尝试。使流动儿童能够享受和本地常住儿童同样的预防接种服务,有效促进了公共卫生服务的均等化。
OBJECTIVE: To investigate the status quo of immunization programs for migrant children under the supervision of Jiangshan community doctor in Yinzhou District, Ningbo City, Zhejiang Province, to analyze the existing causes and shortcomings and to evaluate the effectiveness of immunization programs. Methods: A questionnaire was designed by ourselves to conduct a questionnaire survey of migrant workers’ families in 1800 families with migrant children in this area. The community doctors issued home visits, vaccination certificates, health education and immunization vaccination reports, and used mobile WeChat to establish a mobile Population micro-channel group and other means to supervise the mobile children to complete the various stages of immunization planning tasks. Results: According to the results of the questionnaire survey, the vaccination certificate rate of migrant children under the supervision of community doctors was significantly higher than that of 2012 when compared with that of 2012 with government-funded and free vaccination. By the end of 2013, the eligible immunization coverage of mobile children basically met the requirements of the implementation plan of the national immunization program. In 2013, the incidence of chickenpox was 5.34%, and the incidence of measles was 0.64 ‰, which was lower than that of migrant children in 2012. The floating population’s satisfaction with community hospital immunization services generally increased, reaching 95.20%. Conclusion: The management mode of floating children’s immunization planning under the supervision of the community hospital and the main body of the community doctors conducted a useful exploration and attempt to effectively implement the immunization planning. Enabling migrant children to enjoy the same immunization services as those of their local residents and effectively promoting the equalization of public health services.