Status Quo And Influencing Factors Study On Pregnant And Prenatal Care For Rural Women In Chongqing Project Target Counties

Objective :To know the status quo of pregnant and prenatal care for rural women in Chongqing project target counties. To analysis the factors influencing pregnant and prenatal care utilization of rural women. To provide evidences and baseline datas for designing intervention measures by comparing differences of pregnant and prenatal care utilization between intervention groups and control group.Methods : The study adopted quantitative methods.Chongqing rural women delivered in 2006 were selected into study based on stratified duster sampling, which included 1223 in Rongchang County and 400 in Tongliang County. Four aspects were investigated by questionaire, which including general family information, pregnant care and history of pregnant and delivery, intrapartum care, and postnatal follow-up.Results : (1) Rate of prenatal check-up was 95.58% in Rongchang and 94.49% in Tongliang. Rate of prenatal check-up for 5 tims or more was 61.98% in Rochang and 45.50% in Tongliang. Rate of prenatal check-up in early period was 58.46% in Rochang and 58.00% in Tongliang. Rate of hospital delivery was 92.07% in Rongchang and 95.75% in Tongliang. Rate of postnatal follow-up was 69.34% in Rongchang and 63.25% in Tongliang. Rate of postnatal follow-up for 3 times or more was 28.54% in Rongchang and 20.00% in Tongliang. Rate of systematic administration was 14.96% in Rongchang and 8.00% in Tongliang. Rate of RCMS participation was 62.88% in Ronchang and 69.75% in Tongliang. Rate of MIPS participation was 73.66% in Ronchang and 75.00% in Tongliang. Expense on hospital delivery was high. Mean expense on spontaneous delivery was 1000 yuan in Ronchang and 900 yuan in Tongliang. Mean expense on uterine-incision delivery was 2500 yuan in Rongchang and 2800 yuan in Tongliang. (2) Popularize of pregnant women receiving pregnant knowledge education was not enough. Village clinic did not play its role in knowledge propaganda. The routine examination is not enough in the prenatal check-up. (3) For Rongchang, factors influencing rate of prenatal check-up included MIPS participation, out-migrant working of pregnant women, age of the husband , education of the pregnant women and time to the nearest THC, and in Tongliang they were number of existing children, education of the husband. Factors influencing rate of women taking not less than five times prenatal check-up in Rongchang included MIPS participation, number of existing children, education of the pregnant women , time to the nearest THC and family income, and in Tongliang they were number of existing children, education of the pregnant women and times of pregnancy. Factors influencing prenatal check-up rate in earlier period in Rongchang were number of existing children, MIPS participation, family income and time to the nearest THC, and in Tongliang were number of existing children and education of the husband. Factors influencing hospital delivery rate in Rongchang were whether to get the prenatal care, whether to get the prenatal care for 5 times or more, MIPS participation and education of the pregnant women, in Tongliang were MIPS participation and whether to get the prenatal care. Factors influencing rate of women taking postnatal follow-up not less than three times in Rongchang were MIPS participation, occupation of the pregnant women, whether to get the prenatal care for 5 times or more and time to the nearest village clinic, in Tongliang was MIPS participation. The three intervention groups have no differences in statistics with the control group in coverage of prenatal check-up and time of taking first check-up, etc. However, intervention group three had higher prenatal rate than the rest three groups did. Intervention group one's hospital delivery rate was lower than the rest three groups did. Hospital eutocia expense of intervention group one was higher than that in the rest three groups. Intervention group three had higher uterine-incision delivery than the rest three groups did. Rate of women had postnatal follow-up not less than three times in Rongchang was higher than that in Tongliang. Conclusions: Pregnant and prenatal care utilization of rural women in project target counties was low. Some of the indexs were lower than the rural standard made by ministry of health. To increase rural women's utilization of pregnant and prenatal health care in project-target counties, ensuring healthier birth and child-rearing, we could have the solution as follow: increasing their participation rate of RCMS and MIPS, starting administration card for duration of pregnancy in early stage, reducing fee for hospital delivery, improving MCH worker's service in THC, bringing village clinic into full play on rural pregnant knowledge propaganda and enhancing pregnant women's correct recognition of pregnant and prenatal healthcare. Different intervention measures can be used in different groups to promote utilization of pregnant healthcare services. Then by comparing efficacy of the measures, the best one can be found to improve systematic administration finally.