浙江平湖与广东南海外来已婚育龄女工生殖健康现况研究

发布时间：2018-03-28 02:27

本文选题：流动人口　切入点：女工　出处：《复旦大学》2013年硕士论文

【摘要】：背景目前我国东西部经济发展严重不平衡的现状,造成了大规模人口流动。2010年全国第六次人口普查结果显示：我国跨城市流动人口约有2.21亿,同第五次全国人口普查相比,流动人口增长81.03%。在目前公布流动人口信息的省份中,广东省和浙江省是跨省流动人口规模最大的两个省份。其中浙江省外省流入人口总数达到118万,占常住人口比例的21.7%,广东省外省流入人口总数达到313万,占常住人口比例的30%。外来人口中的女性以外来女工为主,有研究显示,劳动密集型的工作岗位约有70%由外来女工承担。处于育龄期的女工一方面要参加工业生产,另一方面要经历怀孕、分娩、产褥及哺乳等特殊生理过程,健康保障的缺失无疑会给她们的生殖健康造成危害。另外,国内外多项研究显示,外来育龄女工的流动性大、文化水平低、自我保健意识与能力差,这些都使得她们成为生殖健康服务对象中的弱势人群。中国卫生部与联合国儿童基金会于2011-2013年在浙江省平湖市、广东省佛山市南海区开展了流动人口妇幼保健服务试点项目。本研究即为该项目基线调查的一个部分,通过了解两地外来女工的生殖健康现况,以期为更好地为保护这一人群的生殖健康提供依据。研究目的本研究旨在通过对浙江平湖市和广东佛山的南海区两项目区的工厂外来已婚育龄女工的现况调查,以及对相关人员的定性访谈,描述两项目区女工的生殖健康现况,评价项目区现有政策和服务对目标人群生殖健康状况的影响,并探讨在该人群中促进生殖健康的对策和方法。研究方法 1.定量调查：调查工厂的选择是基于：(1)有符合研究需要的目标人群；(2)厂方愿意配合调查；(3)能合作开展后续的干预措施。最终在平湖市选定了3家制衣厂,在南海市选定了1家电子厂、1家内衣厂。研究对象纳入标准为：(1)已婚女工；(2)年龄20-49岁；(3)夫妻双方的户籍均不在项目区。所选工厂内符合条件的女工全部纳入研究。最终在平湖回收有效问卷598份,在南海回收534份。 2.定性调查：采用文献回顾和定性访谈相结合的方式。采用目的抽样的方法,分别选择以下几类对象展开访谈：(1)当地相关政府部门管理者(每地3-4人),如卫生局、流管办、工会、或妇联工作人员；(2)工厂管理者(每厂1人)；(3)女工小组(每厂1组),挑选在外来女工中的已婚未育者、或5岁以下孩子母亲,每组5-7人。两地共访谈了38人。研究结果 1.女工生殖健康现况的定量研究结果 (1)女工及家庭的一般情况：两地女工及其丈夫的学历都以初中为主；平湖女工收入的中位数为15000元,南海女工收入的中位数为10000元；两地女工的户口均以农业户口为主；有孩子的女工在两地均占到95%以上。 (2)女工的生殖健康相关知识情况：知识部分包括了生育保险知识、孕产期保健知识、婴幼儿喂养知识。两地女工生殖健康相关知识知晓率分别为：37.2%(平湖)和48.0%(南海)。平湖女工知识总得分的中位数为5分,南海女工的中位数为6分。多元线性回归分析结果显示,与女工知识得分可能相关的因素有：流入地、流入时间、婚龄、是否有孩子、文化水平、家庭人均年收入等。 (3)女工的生殖健康问题及相关服务利用情况：两地女工月经紊乱症状的发生较为普遍(平湖43.0%,南海50.9%),部分女工存在痛经症状(平湖25.9%,南海34.3%)。部分女工自报存在生殖道可疑感染症状(平湖29.6%,南海39.9%),症状主要是阴道有异常排出物、下腹疼痛等。约1/4的女工1年内被检查出患有妇科病(平湖20.5%,南海26.2%),1年内女工参加过妇女病普查的比例分别是67.9%(平湖)和56.7%(南海),形式主要是工厂组织。： (4)影响生殖健康问题发生情况的相关因素分析：多因素分析结果显示,对于女工的生殖道可疑感染的自报情况,可能的相关因素有：年龄、流入地、知识总得分。对于女工近一年内妇科病检出情况,可能的相关因素有：家庭人均年收入、最近一年内是否参加过妇女病普查。 2.女工、工厂、项目区三方的定性研究结果目前已有一系列关于保护女工生殖健康的政策法规,但由于强制性普遍不强,或与企业的利益冲突,以致部分法规条目不能得到完全的施行。从项目区层面来看,在提供生殖保健服务方面,两地的共性问题是；政府相关投入不足、政府与工厂的配合有待完善。平湖的妇女病普查服务开展情况较好,但存在生育保险的作用被限制、健康宣教服务未形成体系的问题；南海的生育保险利用情况较好、健康宣教服务的开展规律,但存在妇女病普查服务不规范、服务人员短缺的问题。从工厂层面来看,与企业利益有冲突、管理者对女工生殖健康缺乏重视、工作时间不规律,是影响生殖健康服务提供,以及女工生殖健康状况的几个原因。从女工层面来看,流动性大、健康意识差、家庭经济条件不佳、对生育政策知晓度较低等因素影响了女工对生殖保健服务的利用。结论与建议本次调查发现,两项目区的外来已婚育龄女工,生殖健康相关知识水平不高,且相当一部分女工存在生殖健康隐患。在维护外来女工生殖健康的问题上,政府、工厂、女工三方承担着各自应有的责任。针对现实存在的问题,本文提出以下几点建议：打破以户籍制度为核心的二元社会结构,缩小城乡差别：强化政府责任,保证资金和人员到位；通过有效措施强化部门合作；简化社保手续,更好的发挥生育保险的作用；完善现有的女工生殖健康保护政策,加大其推广执行力度；按照分类指导的原则,加强外来女工保健服务的宣传,提高她们利用服务的主动性。
[Abstract]:background
The present situation of economic development in China. The serious imbalance, caused a mass migration.2010 years of the sixth national census shows: Cross City China's floating population of about 221 million, compared with the fifth national census, the floating population growth in the 81.03%. announced the floating population information in the provinces, Guangdong province and Zhejiang Province inter provincial movement of two provinces is the largest population in Zhejiang province. The provinces into the total population reached 1 million 180 thousand, accounting for 21.7% of the proportion of the resident population in Guangdong Province, other provinces into the total population reached 3 million 130 thousand, accounting for the proportion of the resident population of 30%.
The foreign population in women with migrant workers, studies have shown that the labor intensive work undertaken by about 70% migrant workers in the child-bearing age women. On the one hand to participate in industrial production, on the other hand to go through pregnancy, childbirth, breastfeeding and postpartum special physiological process, lack of health insurance will undoubtedly cause harm to their reproductive health. In addition, a number of domestic and foreign research shows that the liquidity of foreign childbearing women, low cultural level, self health care consciousness and ability is poor, which makes them become the disadvantaged groups of reproductive health services in the object.
Chinese the Ministry of health and the United Nations Children's Fund in 2011-2013 years in Zhejiang Province, Pinghu City, Nanhai District of Guangdong city in Foshan province to carry out the floating population maternal and child health services pilot project. This research is a part of the project through the baseline survey, to understand the current status of reproductive health of two female migrant workers, in order to better protect this population provides the basis for reproductive health.
research objective
This study aims to survey on two projects in Pinghu city and Guangdong District of Zhejiang Foshan Nanhai District factory foreign married workers, and qualitative interviews with relevant personnel, described the status of reproductive health of two female workers of the project area, the project area impact assessment of existing policies and services on the health status of the target population reproduction, and to promote countermeasures and methods of reproductive health in this population.
research method
1. quantitative survey: a survey of plant selection is based on: (1) in need of research in line with the target population; (2) the manufacturer is willing to cooperate with the investigation; (3) to follow-up intervention measures of cooperation. The final selection of the 3 garment factory in Pinghu City, in the South China Sea city selected 1 home electronics factory, 1 the object of study into the underwear factory. Standards are as follows: (1) married women; (2) 20-49 years of age; (3) the couple's household was not selected in the project area. The factory meets the conditions of all the women included in the study. The final in Pinghu, 598 valid questionnaires, 534 were recovered in the South China Sea.
2. qualitative investigation: a literature review and qualitative interview method. By purposive sampling, were selected following object interview: (1) local government managers (3-4 each), such as the Health Bureau, the office of the flow tube, union, or women's work; (2 factory managers (per plant) 1); (3) female group (each group 1 Factory), married without a child in the selection of female migrant workers, or children under 5 years old mother, each group of 5-7 people. The two were interviewed 38 people.
Research results
Quantitative research results of 1. female workers' reproductive health
(1) the general situation of women and family: two women and their husbands are in junior high school; the median income of workers in Pinghu for 15000 yuan, the median income of the South China Sea workers is 10000 yuan; the two women's accounts were to agriculture accounts; working mothers are accounted for in two to more than 95%.
(2) the situation of reproductive health knowledge workers: knowledge includes the knowledge of birth insurance, maternal health care knowledge, infant feeding knowledge. Two women were aware of reproductive health related knowledge: 37.2% (Pinghu) and 48% (South China Sea). The median total score of the knowledge workers in Pinghu was 5 and the median of female workers in South China Sea 6. Multiple linear regression analysis showed that female knowledge scores may be related to factors: inflow, inflow time, age of marriage, whether to have children, educational level, family income per capita.
(3) the utilization of reproductive health of female workers and related services: two menstrual disorders are common (43% in Pinghu, 50.9% South China Sea), some women are the symptoms of dysmenorrhea (25.9% in Pinghu, 34.3% South China Sea). Some women self-reported reproductive tract infection symptoms are suspected (29.6% in Pinghu, South China Sea, 39.9%) symptoms is the main abnormal vaginal discharge, abdominal pain. About 1/4 of women within 1 years was diagnosed with gynecological diseases (20.5% in Pinghu, 26.2% South China Sea), 1 years women participated in the survey of women's disease rates were 67.9% (Pinghu) and 56.7% (South China Sea), is the main form of plant tissue:
(4) analysis of factors related to the occurrence of reproductive health problems: multi factor analysis showed that the self-reported reproductive tract infection in women suspected of possible related factors include: age, knowledge inflow, the total score for women. In recent years the detection of gynecological diseases, the related risk factors are: the average annual family income, recent years have participated in the survey of women's diseases.
2. qualitative research results of three parties in women workers, factories and project areas
At present, there are a series of policies and regulations concerning reproductive health protection for women workers. However, due to the general lack of compulsion or conflict with the interests of enterprises, some regulations and items cannot be fully implemented.
From the perspective of the project area, in the provision of reproductive health services, the two are common problems; government investment, government and the factory needs to be improved. The survey of women's diseases service in Pinghu carry out better, but the existence of maternity insurance's role is limited, the health education service has not formed the system; the situation in the South China Sea family the use of insurance good health education service rules, but there are women's disease screening services are not standardized, the service personnel shortage.
From the factory level, there are conflicts with the interests of the enterprises. Managers do not pay much attention to the reproductive health of women workers. The irregular working hours are the reasons that affect reproductive health services and the reproductive health of women workers.
From the perspective of women workers, mobility, health awareness and family economic conditions are not good, and the low awareness of childbearing policy affects the utilization of reproductive health services by female workers.
Conclusions and suggestions
The survey found that the reproductive health related knowledge level of migrant women aged two in the project area is not high, and a considerable part of the female workers have reproductive health risks. In maintaining the reproductive health of migrant women workers, the government, factories, and women workers have three responsibilities.
According to the existing problems, this paper puts forward following suggestions: to break the two yuan of social structure to the household registration system as the core, narrowing the gap between urban and rural: strengthening the government responsibility, guarantee funds and personnel in place; departments to strengthen cooperation through effective measures; simplified social security procedures, better play the role of maternity insurance; improve the female reproductive health protection policy the increase in the promotion of execution; in accordance with the principles of guidance, strengthening the migrant workers health care propaganda, to improve the initiative of their use of services.

【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R173

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