Maternal and child health in Yushu, Qinghai Province, China

International Journal for Equity in Health

Research

Dawa Khandro¹  Karma Lhamo²  Luke C Mullany³  Mary Wellhoner³  Anne CC Lee⁴  Maria Freytsis⁵  Karen Deutsch⁶  Mariette Wiebenga⁷  Phuntsok Dongdrup⁸  Sonam Drogha⁸  Lee Weingrad⁹  Ojen Tsering^1,10 

[1] Completion Primary School, Chenduo, Yushu, Qinghai, China;Department of Gesar, Unit of The Masses Arts of Yushu Tibetan Autonomous Prefecture of Qinghai, China;Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, MD 21205, Baltimore, USA;Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, MD 21205, Baltimore, USA;Department of Newborn Medicine, Brigham and Women's Hospital, 75 Francis Street, MA 02115, Boston, USA;Department of Obstetrics and Gynecology, Woodhull Medical Center, 760 Broadway Brooklyn, NY 11206, USA;Family Health Care Nursing, University of California, San Francisco, 2 Koret Way, CA 94143, San Francisco, USA;Global AIDS Interfaith Alliance, Blantyre, Malawi;Public Health Consultants, Zeist, Netherlands;Surmang Foundation Dharma Saghara Clinic, Yushu, Qinghai, China;Surmang Foundation, 13536 Gold Hill Road, CO 80302, Boulder, USA;Tibet Gzi-road Culture Communication Ltd,.Co., Xining, Qinghai, China;Dronme Association for Education and Eradication of Poverty, Xining, Qinghai, China;

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

DOI  :  10.1186/1475-9276-10-42

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

来源: Springer

【 摘 要 】

IntroductionSurmang, 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.MethodsA 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.ResultsWomen'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.ConclusionsWhile 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】

CC BY   
© Wellhoner et al; licensee BioMed Central Ltd. 2011