| Maternal mortality rate is high in rural areas of China.The level of perinatal care is much different between urban and rural areas,which seriously affected the life quality of women.It is urgent to resolve the poor situation of maternal health in rural areas,and it's also one of important contents in women and child health work.Since 2000,Ministry of Health and National Working Committee on Children and Women under the State Council cooperate with Ministry of Finance to carry out the Decreasing Maternal Mortality Rate and Neonatal Tetanus Morbidity Project(DM&N Project).This project aims to solve the prominent problems which may threaten the women and children's survival,healthcare and development.ObjectiveTo understand the condition and trends of maternal health in poor rural areas.To explore the main factors which impact maternal health in these areas,and the impact ways.To provide recommendations for the next step of maternal health work in rural areas.Methods:1.We select 11 provinces randomized and stratified.In each province,we select 2 county randomized from counties where are doing the DM&N Project,a total of 22 counties.We interview the staffer who is in charge of maternal and children health and collect maternal and child health statistics.2.Select one country randomized in each county that we visit.We copy 10 women systematic management card in each country.3.In all the counties that we visited,we select 2 countries randomized in each county.We select 2 villages in each country and interview 3～5 mothers who have child under age 5(include pregnant women) with filling out the questionnaires. Totally,we interview 314 women.4.We select 269 counties which implemented the "DM&N" project in 11 selected provinces in 2000.Results:1.From 1999 to 2005,maternal mortality rate and hospitalized delivery rate improve greatly,other indexes are also in high level.However,there still exist fluctuation on maternal mortality rate.There are still some difference of maternal health level in different regions.The maternal health indexes of North-west region improve significantly.2.Most pregnant women have 5 times antenatal care,but only 48.3%women have systematic antenatal care.Most pregnant women can complete medical examination. About 90%pregnant women have measured their blood pressure.But the situation of taking laboratory examination is poor.Only 34.8%women had at least one time high-risk score.3.The mothers who have children under 5 years old have good knowledge of maternal healthcare and need maternal healthcare knowledge strongly.They also take antenatal care and hospitalized delivery.Education level is the main risk factor of taking antenatal care.The women who have junior middle school education level have better antenatal care than those who have primary education level.OR=2.591.4.Many factors impact maternal mortality rate and hospitalized delivery rate.The main factors are community factors.In 2005,health care factors impact maternal mortality rate more obviously.Health Resources factors are not the main factors to affect maternal mortality rate.Health resources factors and community factors are more important for hospitalized delivery rate.Conclusion and suggestions:The level of perinatal care have been improved,however,fluctuation still exist. There are still some problems in systematic antenatal care.Many examinations are not been taken.The mothers who have children under 5 years old have good knowledge of maternal healthcare.The level of education is the main factors affecting women's antenatal care situation.Health care and community factors affect maternal mortality rate and hospitalized delivery rate greatly.Improving creasing hospitalized delivery rate and antenatal care can reduce maternal mortality rate.The suggestions are as below:1.Promoting and applying obstetric appropriate technology to reduce maternal mortality rate.2.It's need to increase the quality of antenatal care and to focus on management of high-risk pregnant women.3.It's also need to improve rural women knowledge and to develop targeted health education.
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