Skip to main content
Log in

Factors influencing the utilization of postpartum visits among rural women in China

  • Published:
Journal of Huazhong University of Science and Technology [Medical Sciences] Aims and scope Submit manuscript

Summary

Postpartum visits (PPVs) are still underutilized in rural China, and identification of factors that influence PPV use is important in ensuring the utilization of maternal health services and for wellbeing of women. A cross-section study was undertaken to collect related data from 347 rural women interviewed six weeks or more after delivery, and an ANOVA was performed to find whether there were significant differences in the number of PPVs among different rural areas in China. According to Andersen’s socio-behavioral model of health service use, factors were divided into equitable and inequitable ones. Chi-squared test, univariate and multiple analyses were used to determine the equity of PPV use by identifying factors that were most strongly associated with the use of a PPV. The results showed that 20.2% of the respondents (n=70) did not receive any PPVs, and 62.5% (n=173) of those who had PPVs (n=277) did not receive standard PPVs (referring to at least 3 visits). There was no significant difference among different rural areas in terms of the number of PPVs (F=1.514, P=0.211). Multiple regression analyses revealed that enabling factors such as compensation for delivery expense [OR (95% CI)=2.825 (1.331, 5.995)], village type [OR (95% CI)=1.802 (1.021, 3.182)] and service quality [OR (95% CI)=1.847 (1.074, 3.176)] were strongly associated with PPV use. Both enabling factors such as home visits [OR (95% CI)=1.855 (1.085, 3.174)], service quality [OR (95% CI)=1.993 (1.155, 3.439)] and need factors such as low birth weight [OR (95% CI)=4.424 (1.482, 13.203)] were significantly associated with standard PPV use. Our results suggested that the equitable access to PPVs has been considerably improved in rural areas in China. The associations between inequitable factors and PPV use warrant further exploration, and policies aimed at improving quality and patterns of service supply are needed in order to ensure a full equitable access to maternal health services.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. WHO. Postpartum care of the mother and newborn: a practical guide. Technical Working Group, World Health Organization. Birth, 1999, 26(4):255–258

    Article  Google Scholar 

  2. Högberg U. The World Health Report 2005: “Make every mother and child count”—Including Africans. Scand J Public Healt, 2005, 33(6):409–411

    Article  Google Scholar 

  3. Darmstadt GL, Bhutta ZA, Cousens S, et al. Evidencebased, cost-effective interventions: how many newborn babies can we save? Lancet, 2005, 365(9463):977–988

    Article  PubMed  Google Scholar 

  4. Quinlivan JA, Box H, Evans SF. Postnatal home visits in teenage mothers: a randomised controlled trial. Lancet, 2003, 361(9361):893–900

    Article  PubMed  Google Scholar 

  5. MacArthur C, Lewis M, Knox EG. Health after childbirth. BJOG: Int J Gynaecol Obstet, 1991, 98(12):1193–1195

    Article  CAS  Google Scholar 

  6. Adam T, Lim SS, Mehta S, et al. Achieving the millennium development goals for health — Cost effectiveness analysis of strategies for maternal and neonatal health in developing countries. Brit Med J, 2005, 331(11):1107–1110

    Article  PubMed Central  PubMed  Google Scholar 

  7. Kerber KJ, de Graft-Johnson JE, Bhutta ZA, et al. Continuum of care for maternal, newborn, and child health: from slogan to service delivery. Lancet, 2007, 370(9595):1358–1369

    Article  PubMed  Google Scholar 

  8. China’s Ministry Of Health. The management measure of systematic maternal healthcare in rural areas. 1989

    Google Scholar 

  9. China’s Ministry Of Health. Report of the 4th national health service survey in China. Beijing: Xiehe Medical University, 2008

    Google Scholar 

  10. Yuan J, Peng L, Yimin Z. Trend analysis on utilization of health care services for Chinese women of childbearing age during pregnant and puerperal period from 1993 to 2008. Zhong Guo Fu You Bao Jian (Chinese), 2012, 27(2):170–172

    Google Scholar 

  11. The State Council of China: Implementation plan for the recent priorities of the health care system reform (2009–2011). Beijing: The State Council of China, 2009.

    Google Scholar 

  12. UNDP. China Human Development Report. 2009/10: China and a sustainable future: towards a low carbon economy and society. 2010. http://hdr.undp.org/en/reports/national/asiathepacific/china/Chine_2010.pdf

    Google Scholar 

  13. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav, 1995, 36(1):1–10

    Article  CAS  PubMed  Google Scholar 

  14. China’s Ministry Of Health. Standard Specification of National Essential Public Health Services (2011)

    Google Scholar 

  15. Huang L, Sauve R, Birkett N, et al. Maternal age and risk of stillbirth: a systematic review. Can Med Assoc J, 2008, 178(2):165–172

    Article  Google Scholar 

  16. China’s National Bureau of Statistics. China Statistical Yearbook 2011: China Statistics Press, 2011

    Google Scholar 

  17. Landy CK, Sword W, Ciliska D. Urban women’s socioeconomic status, health service needs and utilization in the four weeks after postpartum hospital discharge: findings of a Canadian cross-sectional survey. Bmc Health Serv Res, 2008, 8(1):203

    Article  Google Scholar 

  18. Sword WA, Krueger PD, Watt MS. Predictors of acceptance of a postpartum public health nurse home visit — Findings from an Ontario survey. Can J Public Health, 2006, 97(3):191–196

    PubMed  Google Scholar 

  19. Parkhurst JO, Ssengooba F. Assessing access barriers to maternal health care: measuring bypassing to identify health centre needs in rural Uganda. Health Policy Plann, 2009, 24(5):377–384

    Article  Google Scholar 

  20. Raven JH, Chen Q, Tolhurst RJ, et al. Traditional beliefs and practices in the postpartum period in Fujian Province, China: a qualitative study. BMC Pregnancy Childbirth, 2007, 7(1):8

    Article  PubMed Central  PubMed  Google Scholar 

  21. WHO, UNICEF. Home visits for the newborn child: a strategy to improve survival. 2009. http://www.unicef.org/health/files/WHO_FCH_CAH_09.02_eng.pdf

    Google Scholar 

  22. Titaley CR, Dibley MJ, Roberts CL. Factors associated with non-utilisation of postnatal care services in Indonesia. J Epidemiol Commun H, 2009, 63(10):827–831

    Article  CAS  Google Scholar 

  23. Marchant T, Willey B, Katz J, et al. Neonatal mortality risk associated with preterm birth in east Africa, adjusted by weight for gestational age: individual participant level meta-analysis. PLoS Med, 2012, 9(8):e1001292

    Article  PubMed Central  PubMed  Google Scholar 

  24. Wilcox AJ. On the importance—and the unimportance—of birthweight. Int J Epidemiol, 2001, 30(6):1233–1241

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zhan-chun Feng  (冯占春).

Additional information

Both authors contributed equally to this work.

This project was supported by the National Natural Science Foundation of China (No. 71273097).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xiang, Yx., Xiong, Jy., Tian, Mm. et al. Factors influencing the utilization of postpartum visits among rural women in China. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 34, 869–874 (2014). https://doi.org/10.1007/s11596-014-1366-1

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-014-1366-1

Key words

Navigation