Equity in use of maternal health services in Western Rural China: a survey from Shaanxi province

BMC Health Services Research

Zhongliang Zhou²  Jianmin Gao²  Shengbin Xiao¹  Qiang Li¹  Klemetti Reija³  Hong Yan¹  Yuan Shen¹ 

[1] Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi 710061, P.R. China;School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, P.R. China;THL, National Institute for Health and Welfare, P.O. Box 30, Helsinki FI-00271, Finland

关键词: Economic situation;    Maternal and child health service;    Equity;   

Others  :  1132799
DOI  :  10.1186/1472-6963-14-155

 received in 2013-12-17, accepted in 2014-04-01,  发布年份 2014

【 摘 要 】

Background

The 20^th century was marked by a significant improvement in worldwide human health and access to healthcare. However, these improvements were not completely or uniformly distributed among, or even within, nations. This study was designed to assess the use of maternal health services by pregnant women in China, with a focus on the inequity related to family income level.

Methods

Two population-based cross-sectional surveys were carried out in the Zhenan and Lantian counties in March 2007 and from December 2008 to March 2009. A total of 2562 women completed the questionnaires, including 948 who were pregnant in 2006 and 1614 from 2008–2009. The concentration index (CI) was calculated and used to analyze the parameters of maternal health care in the two counties surveyed.

Results

The responses in both 2006 and 2008–2009 indicated a bias towards higher (rich) economic statuses for the use of maternal and child health services. The CI of ‘delivery at health facility’ was 0.0206 (95% confidence interval between 0.0114 and 0.0299) for 2006 and 0.0053 (95% confidence interval between 0.0015 and 0.0091) for 2008, which represented a statistically significant inequity for women of lower (poor) economic statuses. Similar CI was observed in ‘receiving antenatal care within 12 weeks’ for 2006 (CI₂₀₀₆ = 0.0956, 95% confidence interval between 0.0516 and 0.1396). The CIs of ‘postnatal visit’ and ‘postnatal visit >3-times’ was positive (except for 2006), indicating that the poor used postnatal care less than the non-poor. In 2008, poor women had C-sections more often than non-poor women (CI₂₀₀₈ = −0.0629, 95% confidence interval between-0.1165 and −0.0093), but such a difference was not observed in 2006.

Conclusions

In 2006 and 2008, the use of maternal health services in western rural China was significantly unequal between pregnant women of poor and non-poor economic statuses. Financial support that enables poorer pregnant women to use health services will be beneficial. Utilization of maternal healthcare services can be improved if out-of-pocket expenses can be minimized.

【 授权许可】

   
2014 Shen et al.; licensee BioMed Central Ltd.

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