目的了解分析广东省产科资源配置的公平性现况,为卫生行政部门制定相关的妇幼卫生决策和措施提供依据。方法调查收集广东省所有助产机构产科资源相关数据,利用洛伦茨曲线(Lorenz curve)和基尼系数(Gini coefficient)分析评价产科资源,按分娩量、常住人口和土地面积分布的公平性,并以贡献系数作为判断不公平因子的依据,分析全省不公平因子分布的空间差异性。结果 2015年广东省助产机构、母婴保健技术考核合格人员、产科医生、护士及床位各产科资源按土地面积分布的基尼系数均在0. 6以上;按常住人口和分娩量分布,均仅助产机构的基尼系数> 0. 4。深圳和东莞母婴保健技术考核合格人员、产科医生、护士和床位的土地面积贡献系数,以及深圳助产机构、顺德母婴保健技术考核合格人员、产科护士的土地面积贡献系数最小(<0. 25),单位面积配置的资源较多,梅州、河源、韶关、清远和肇庆的母婴保健技术考核合格人员、产科医生、护士和床位土地面积贡献系数,以及清远和河源的助产机构土地面积贡献系数、云浮产科医生以及阳江产科护士、母婴保健技术考核合格人员的土地面积贡献系数最大(≥1. 75),这些地区单位面积配置的资源较少。结论广东省母婴保健技术考核合格人员、产科医生、护士和床位按常住人口和分娩量分布公平性较好,但助产机构均处于警戒状态;各产科资源按土地面积分布的公平性较差。深圳、东莞、顺德、梅州、河源、韶关、清远、肇庆、云浮和阳江产科资源分布的差异是引起全省产科资源按土地分布不公平的主要原因。

Objective To assess equity and inequity in obstetric resource allocation for the purpose of providing information on policy-making in women and children's health care. Methods Obstetrics resources related data of Guangdong province in all the institutions of midwifery were collected,and Lorenz curve and Gini coefficient were used to analyze and evaluate the equity of obstetric resources distribution according to delivery number,resident population and land area. Taking contribution coefficient as the basis of judging unfair factor,the spatial difference of distribution of unfair factor in the whole province was analyzed. Results According to the size of area,the Gini coefficient of midwifery institutions,maternal and infant health care technology assessment qualified personnel,obstetricians,nurses,and maternity beds were greater than 0. 6,and only that of midwifery institutions was greater than0. 4,when assessed by the size of the population and the number ofd by the s. According to the size of area,the contribution coefficient of maternal and infant health care technology assessment qualified personnel,obstetricians,nurses,and maternity beds in Shenzhen and Dongguan,and that of midwifery institutions in Shenzhen,maternal and infant health care technology assessment qualified personnel and nurses in Shunde were least(less than 0. 25). The contribution coefficient of maternal and infant health care technology assessment qualified personnel,obstetricians,nurses,and maternity beds in Meizhou,Heyuan,Shaoguan,Qingyuan and Zhaoqing,and that of midwifery institutions in Qingyuan,Heyuan,and obstetricians in Yunfu,maternal and infant health care technology assessment qualified personnel and nurses in Yangjiang were largest(more than 1. 75). Conclusion When assessed by the size of population and the number of delivery,equity was observed in the number of maternal and infant health care technology assessment qualified personnel,obstetricians,nurses,and maternity beds,some inequity was noticed in the number of midwifery institutions.Inequity was present in all of the aspects when assessed by the size of area. The differences of obstetric resource distribution in Shenzhen,Dongguan,Shunde,Meizhou,Heyuan,Shaoguan,Qingyuan,Zhaoqing,Yunfu and Yangjiang,was the main causes of inequity when assessed by the size of area.