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Changes and Equity in Use of Maternal Health Care in China: from 1991 to 2003

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Abstract

To examine changes and equity in use of maternal care in different types of rural and urban areas in China from the early 1990s to early 2000s. Data were drawn from three National Health Household Interview Surveys conducted in 1993, 1998, and 2003. Analysis was based on married women aged between 15 and 49 who had live births within the 24 months prior to the survey. Nationally, the proportion of women receiving their first pre-natal visit within 12 weeks of gestation and the hospital delivery rate increased rapidly from 20.56 and 37.61% in the early 1990s to 52.60 and 74.02% in the early 2000s, respectively, while the proportion of women receiving at least one post-natal care visit dropped slightly from 56.46 to 54.12% in the same time period. There were large disparities in use of maternal care between urban and rural areas and among different sized cities and rural areas with different levels of socio-economic development. But the disparities narrowed over time, especially among different types of rural areas. The proportion of delivery out of hospital attended by trained staff in rural areas decreased considerably from 68.01% in 1991–1993 to 51.57% in 2001–2003. Maternal care utilization made remarkable progress in the study period, and the gap between rural and urban areas and among different classes of cities and rural areas significantly narrowed. This was probably due to both socio-economic development and targeted investments in improving health services. However, significant gaps remained, requiring attention.

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Notes

  1. The population of a large city was above 1 million, and a small city was categorized as less than 0.3 million. The size of a city tends to be indicative of a higher level of economic development and a greater allocation of healthcare resources.

References

  1. Tang, S., Meng, Q., Chen, L., Bekedam, H., Evans, T., & Whitehead, M. (2008). Tackling the challenge to health equity in China. Lancet, 372, 1493–1501.

    Article  PubMed  Google Scholar 

  2. Feng, X., Tang, S., Bloom, G., Segall, M., & Gu, X. (1995). Cooperative medical schemes in rural China. Social Science and Medicine, 41, 1111–1118.

    Article  PubMed  CAS  Google Scholar 

  3. Liu, Y., Rao, K., & Fei, J. (1998). Economic transition and health transition: comparing China and Russia. Health Policy, 44, 103–122.

    Article  PubMed  CAS  Google Scholar 

  4. Ministry of Health. (2007). China health statistics yearbook 2007. Beijing: China Union Medical University Press.

    Google Scholar 

  5. Kaufman, J., & Jing, F. (2002). Privatization of health services and the reproductive health of rural Chinese women. Reproductive Health Matters, 10, 108–116.

    Article  PubMed  Google Scholar 

  6. Gao, J., Qian, J., Tang, S., Eriksson, B., & Blas, E. (2002). Health equity in transition from planned to market economy in China. Health policy and Planning, 17(Suppl 1), 20–29. Oxford University Press.

    Article  PubMed  Google Scholar 

  7. Gu, X., Tang, S., & Gao, S. (1995). The financing and organization of health services in poor rural China: A case study in Donglan County. International Journal of Health Planning and Management, 10, 265–282.

    Article  PubMed  CAS  Google Scholar 

  8. Tang, S., & Bloom, G. (2000). Decentralizing rural health services: A case study in China. International Journal of Health Planning and Management., 15, 189–200.

    Article  PubMed  CAS  Google Scholar 

  9. The MDG Africa Steering Group. (2008). Achieving the millennium development goals in Africa: Recommendations of the MDG Africa steering group.

  10. Countdown Coverage Writing Group. (2008). Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking coverage of interventions. Lancet, 371, 1247–1258.

    Article  Google Scholar 

  11. Guo, Y., Zakus, D., & Liang, H. (2008). China: Policy and practice of MCH since 1990 s. Maternal and Child Health Journal, 12, 138–148.

    Article  Google Scholar 

  12. Tang, S., Li, X., & Wu, Z. (2006). Rising cesarean delivery rate in primiparous women in urban China: Evidence from three nationwide household health surveys. American Journal of Obstetrics and Gynecology, 195, 1527–1532.

    Article  PubMed  Google Scholar 

  13. Center for Health Statistics and Information, MOH. (2004). An analysis report of national health services survey in 2003. Xiehe Medical University Press.

  14. Ministry of Health. Guideline on quality of maternal care for both urban and rual areas. http://www.people.com.cn/item/flfgk/gwyfg/1985/407104198502.html.

  15. Anson, O. (2004). Utilization of maternal care in rural Hebei province, the People’s Republic of China: Individual and structural characteristics. Health Policy, 70, 197–206.

    Article  PubMed  Google Scholar 

  16. Liu, Y., & Liu, G. (2007). Summary report of strengthening China Basic Health Services Project. China: Political and Financial Press.

  17. Tolhurst, R., Zhang, T., Yang, H., Gao, J., & Tang, S. (2004). Factors affecting the implementation of health legislation and its impact on the rural poor in China: A case study of implementation of the Maternal and Infant Health care Law in two poor counties. International Journal of Health Planning and Management, 19, 247–265.

    Article  PubMed  Google Scholar 

  18. Park, R. (1996). China’s great achievement in strengthening MCH/FP at grassroots level program. Maternal and Child Health Care of China, 11(6), 21.

    Google Scholar 

  19. Wang, F. L. (1996). Push MCH by making great effort to do cooperative health projects. Maternal and Child Health Care of China, 11(6), 2–10.

    Google Scholar 

  20. Wang, Y. Z. (2004). An investigation on public health issues in western China. Review of Economics Research 54, 2–8, 33.

    Google Scholar 

  21. Chen, H., et al. (2004). Evaluation on maternal health of Health VI project at village level. Maternal and Child Health Care of China, 18(9), 524–526.

    CAS  Google Scholar 

  22. Peng, Y. (2000). Fulfill the goals set in the “Women and Children Development planning” by careful implementing the project “Reduce the maternal mortality and eliminate the incidence of tetanus infection of newborn babies”. Maternal and Child Health Care of China, 15(2), 68–72.

    CAS  Google Scholar 

  23. MOH. (2003). A summary of the project of “Decrease the maternal mortality and annual newborn infant tetanus”. http://www.MOH.gov.cn.

  24. Yan, G., Zhuochun, W., Huijing, S., et al. (2007). Effects of health VIII project on maternal health service utilization. Chinese Primary Health Care, 21(12), 8–10.

    CAS  Google Scholar 

  25. Tao F. B., Huang K., Long X., Tolhurst R., & Raven J. (2010). Low postnatal care rates in two rural counties in Anhui province China: Perceptions of key stakeholders, Midwifery (forthcoming).

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Acknowledgments

This document is an output from the project “Structural hinders to and promoters of good maternal care in rural China—CHIMACA (015396)”, funded by the European Commission INCO Program and co-ordinated by the National Institute for Health and Welfare, Helsinki, Finland.

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Authors and Affiliations

  1. Department of Health Statistics and Social Medicine, Fudan University School of Public Health, 138 Yi Xue Yuan Road, Shanghai, 200032, People’s Republic of China

    Zhuochun Wu & Peng Lei

  2. Department of Public Health, University of Helsinki, Helsinki, Finland

    Zhuochun Wu

  3. National Institute for Health and Welfare (THL), P.O. Box 220, 00531, Helsinki, Finland

    Elina Hemminki

  4. Center for Health Statistics and Information, Ministry of Health, Beijing, China

    Ling Xu & Jun Gao

  5. Liverpool School of Tropical Medicine, Liverpool, UK

    Shenglan Tang, Joanna Raven & Rachel Tolhurst

  6. Center for Disease Control and Prevention, Ministry of Health, Beijing, China

    Xiaoyan Li

Authors
  1. Zhuochun Wu
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  2. Peng Lei
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  3. Elina Hemminki
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  4. Ling Xu
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  5. Shenglan Tang
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  6. Xiaoyan Li
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  7. Joanna Raven
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  8. Jun Gao
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  9. Rachel Tolhurst
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Corresponding author

Correspondence to Zhuochun Wu.

Appendix

Appendix

See Table 6.

Table 6 Major programmes aiming to improve maternal and child health in rural China: 1990–2006
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Wu, Z., Lei, P., Hemminki, E. et al. Changes and Equity in Use of Maternal Health Care in China: from 1991 to 2003. Matern Child Health J 16, 501–509 (2012). https://doi.org/10.1007/s10995-011-0773-1

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  • DOI: https://doi.org/10.1007/s10995-011-0773-1

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