Maternal and child health in Yushu, Qinghai Province, China

International Journal for Equity in Health

Lee Weingrad⁷  Luke C Mullany²  Dawa Khandro³  Tseyongjee⁵  Ojen Tsering¹  Karma Lhamo^1,10  Phuntsok Dongdrup^1,11  Sonam Drogha^1,11  Maria Freytsis⁸  Mariette Wiebenga⁴  Karen Deutsch⁹  Anne CC Lee⁶  Mary Wellhoner² 

[1] Tibet Gzi-road Culture Communication Ltd,.Co., Xining, Qinghai, China;Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205 USA;Completion Primary School, Chenduo, Yushu, Qinghai, China;Public Health Consultants, Zeist, Netherlands;Department of Global Community Health and Behavioral Science, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112 USA;Department of Newborn Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115 USA;Surmang Foundation, 13536 Gold Hill Road, Boulder, CO 80302 USA;Department of Obstetrics and Gynecology, Woodhull Medical Center, 760 Broadway Brooklyn, NY 11206 USA;Global AIDS Interfaith Alliance, Blantyre, Malawi;Department of Gesar, Unit of The Masses Arts of Yushu Tibetan Autonomous Prefecture of Qinghai, China;Surmang Foundation Dharma Saghara Clinic, Yushu, Qinghai, China

关键词: Yushu earthquake;    newborn health;    child health;    maternal health;    maternal mortality;    maternal morbidity;    institutional delivery;    facility delivery;    China;    Yushu;    Qinghai;    Tibetan;   

Others  :  829609
DOI  :  10.1186/1475-9276-10-42

 received in 2011-04-08, accepted in 2011-10-04,  发布年份 2011

【 摘 要 】

Introduction

Surmang, Qinghai Province is a rural nomadic Tibetan region in western China recently devastated by the 2010 Yushu earthquake; little information is available on access and coverage of maternal and child health services.

Methods

A cross-sectional household survey was conducted in August 2004. 402 women of reproductive age (15-50) were interviewed regarding their pregnancy history, access to and utilization of health care, and infant and child health care practices.

Results

Women's access to education was low at 15% for any formal schooling; adult female literacy was <20%. One third of women received any antenatal care during their last pregnancy. Institutional delivery and skilled birth attendance were <1%, and there were no reported cesarean deliveries. Birth was commonly attended by a female relative, and 8% of women delivered alone. Use of unsterilized instrument to cut the umbilical cord was nearly universal (94%), while coverage for tetanus toxoid immunization was only 14%. Traditional Tibetan healers were frequently sought for problems during pregnancy (70%), the postpartum period (87%), and for childhood illnesses (74%). Western medicine (61%) was preferred over Tibetan medicine (9%) for preventive antenatal care. The average time to reach a health facility was 4.3 hours. Postpartum infectious morbidity appeared to be high, but only 3% of women with postpartum problems received western medical care. 64% of recently pregnant women reported that they were very worried about dying in childbirth. The community reported 3 maternal deaths and 103 live births in the 19 months prior to the survey.

Conclusions

While China is on track to achieve national Millennium Development Goal targets for maternal and child health, women and children in Surmang suffer from substantial health inequities in access to antenatal, skilled birth and postpartum care. Institutional delivery, skilled attendance and cesarean delivery are virtually inaccessible, and consequently maternal and infant morbidity and mortality are likely high. Urgent action is needed to improve access to maternal, neonatal and child health care in these marginalized populations. The reconstruction after the recent earthquake provides a unique opportunity to link this population with the health system.

【 授权许可】

   
2011 Wellhoner et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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