Low uptake of maternal health care in a remote Chinese region.
Article Type: Report
Subject: Maternal health services (Demographic aspects)
Maternal health services (Social aspects)
Mothers (Patient outcomes)
Mothers (Risk factors)
Mothers (Control)
Pub Date: 11/01/2010
Publication: Name: Reproductive Health Matters Publisher: Elsevier Science Publishers Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: Nov, 2010 Source Volume: 18 Source Issue: 36
Topic: Event Code: 290 Public affairs
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 247520192
Full Text: Maternal mortality in China has dropped since 1990 but rates are highest in rural and remote areas, where minority women live. This study examines the maternal health-seeking practices of minority Yi and Mong women in a remote, resource-constrained region of Sichuan Province. Data were collected through semi-formal interviews with 56 women, including seven traditional birth attendants, two male traditional healers/ astrologers who attend to pregnant and birthing women, five health workers at the township hospital, six managers and staff at the County Hospital, and two administrators at the County Bureau of Health. Opportunistic observations and informal interviews were conducted with maternal and child health workers from other township hospitals and village health posts. A detailed analysis was undertaken of the 62 live births from 1998-2007 at the township hospital, as well as current pregnancies. Maternal health service use is very low. Antenatal care is only received by a minority and postnatal care is even less common. Women are staying at home for reasons of cost that extend beyond the cost of hospital birth itself, the poor quality of township hospitals, the cultural inappropriateness of hospital birthing practices, and lack of incentives, such as pain relief during labour. Utilisation is not necessarily increased through easy access to a health facility. There is potential for improving utilisation through developing the role of village-based health care workers, expanding mobile antenatal care clinics, working with traditional birth attendants, and changing the way township hospital services are provided and funded. There is a need to improve women's understanding of appropriate antenatal care and emergency obstetric care. Current policies that impose punitive measures on struggling township-level staff for not reaching impossible targets for hospital births could be replaced by greater professional and financial support. (1)

(1.) Harris A, Zhou Y, Liao H, et al. Challenges to maternal health care utilization among ethnic minority women in a resource-poor region of Sichuan Province, China. Health Policy and Planning 2010;25(4):311-18.
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