Research On The Utilization Of Antenatal Care Based On The Andersen’s Behavioral Model Of Health Services Use

Objective:The aim of this study was to investigate the current status of antenatal careutilization in JiLin Province, and compare the difference of antenatal care utilizationbetween urban and rural women. Analyze the factors influencing antenatal careutilization based on the framework of Andersen’s Behavioral Model of HealthServices Use, and analyze the factors affected antenatal care utilization. All of thesewould be reference for hospital and administrative department to improve the qualityof antenatal care.Methods:The self-designed questionnaire was applied on601women in JiLin Province.The questionnaire includes two sections:(1)the antenatal care utilization in JiLinProvince;(2) the influencing factors of antenatal care based on the framework ofAndersen medical services behavioral models. The both software of EpiData3.02andSPSS17.0were applied to establish a database and analyze the data. According thecharacteristic of study material and study objective to choose chi-square test、logisticregression test or other statistic methods.Results:1.234of601pregnant and parturient women (38.9%) had a preconceptional care,among which,65.0%(152/234) was from urban area and35.0%(82/234) was fromrural area; The rate of preconceptional care among pregnant and parturient women inurban area is more higher than those in rural area（P<0.05）.99.2%(596/601) pregnantand parturient women had prenatal care utilization, among which,50.3%(300/601)was from urban area, and49.7(296/601) was from rural area. There was notsignificant difference of prenatal care among urban and rural pregnant and parturient women. The mean basic checkup items was12.88±5.36, while the pregnant andparturient women from urban area was15.13±4.38，the pregnant and parturientwomen from rural area was10.64±5.32, there was significant difference betweenthem(t=-11.286,P<0.05).91.9%(548/596) pregnant and parturient women who hadprenatal care utilization had their first antenatal care within12weeks, among which,50.7%(278/596) was from urban area and49.3%(270/596) was from rural area. Therewas not significant difference of their first antenatal care weeks among urban andrural pregnant and parturient women.70.1%(418/601) had five or more visits, amongwhich,52.9%(221/418) was from urban area and47.1%（197/418）was from rural area.There was not significant difference among antenatal care visits.56.5%(337/596)pregnant and parturient women had qualified antenatal care utilization, among which,60.5%(204/337) was from urban area and39.5%(133/337) was from rural area. Therewas significant difference of qualified antenatal care utilization among urban andrural pregnant and parturient women.2. There are significant differences among pregnant and parturient women’s rateof preconceptonal care in urban area in terms of educational level、spouse educationallevel、occupation、considering necessary to use preconceptional care、knowing thesuitable recumbent position during middle and late trimester、knowing the range ofweight gain during pregnancy; household income; planning pregnancy. Based on thelogistic regression analysis results, knowing the range of weight gain duringpregnancy、 household income、planning pregnancy enter into the final model. Thereare significant differences among pregnant and parturient women’s rate ofpreconceptonal care in rural area in terms of educational level、spouse educationallevel、considering necessary to use preconceptional care、knowing the range of weightgain during pregnancy; distance between living place and the nearest hospital, thetime spent from living place to the nearest hospital. Based on the logistic regressionanalysis results, spouse educational level、 considering necessary to usepreconceptional care、the time spent from living place to the nearest hospital enterinto the final model. 3. There are significant differences among pregnant and parturient women’s rateof qualified antenatal care utilization in urban area in terms of educational level、spouse educational level、occupation、spouse occupation、considering necessary to usepreconceptional care、knowing the suitable recumbent position during middle and latetrimester、knowing the range of weight gain during pregnancy; household income;planning pregnancy. Based on the logistic regression analysis results, educationallevel、spouse educational level；planning pregnancy enter into the final model. Thereare significant differences among pregnant and parturient women’s rate of qualifiedantenatal care utilization in rural area in terms of educational level、consideringnecessary to use preconceptional care、household income; planning pregnancy. Basedon the logistic regression analysis results, household income; planning pregnancyenter into the final model.Conclusions:1. The rate of preconceptional care among pregnant and parturient women inJiLin Province was not high, and the utilization of preconceptional care amongpregnant and parturient women in urban area was better than rural area. Theutilization of antenatal care was still underutilized although which has been improvedin generally.2. Knowing the range of weight gain during pregnancy、household income;planning pregnancy were influencing factors that impact on the utilization ofpreconceptional care among urban pregnant and parturient women. Spouseeducational level、 considering necessary to use preconceptional care、the time spentfrom living place to the nearest hospital were influencing factors that impact on theutilization of preconceptional care among rural pregnant and parturient women.3. Educational level、spouse educational level、planning pregnancy wereinfluencing factors that impact on the qualified antenatal care utilization amongpregnant and parturient women in urban area. Considering necessary to usepreconceptional care; household income were influencing factors that impact on the qualified antenatal care utilization among pregnant and parturient wo men in ruralarea.