Status Quo After Intervention And Interventional Impact Appraisal: A Study Of Antenatal Care For Rural Women In Rongchang, Chongqing

Objective: To explore the status quo of antenatal care (ANC) for rural women in project target county Rongchang, Chongqing. To analyse the factors influencing ANC utilization by rural women. To compare the differences among control and intervention groups in ANC utilization. To estimate the interventional impact. To sum up problems we met in our study, and provide experience for future interventions.Methods: Quantitative study was adopted. CHIMACA project Questionnaire for post-intervention interview survey for women and for relatives were made. Stratified cluster sampling was adopted to select rural women who underwent delivery from April 1st to Dec. 31st, 2008. Data was analysed with SPSS 15.0 for Windows.Results: (1) Nine hundred and eighty women were included in the study. Seven hundred of them were surveyed. The response rate was 71.43%. (2) Antenatal visit coverage rate was 98.78% with eight women discarding antenatal visit. Five times or higher antenatal visit rate was 71.36% with the median antenatal visit time of six. Earlier pregnancy antenatal visit rate was 75.40% with the median time of the third month. (3) Factors affecting antenatal visit coverage rate were educational level of women and their husbands, time to the nearest village clinic, pregnancy frequency and present child number; factor affecting five times or higher antenatal visit rate was time to the nearest township health care center (THC); factors affecting earlier pregnancy antenatal visit rate were educational level of women and their husbands, time to the nearest THC, and new cooperative medical scheme (NCMS) participation. (4) Comparing control group with intervention groups, antenatal visit coverage rate and five times or higher antenatal visit rate were insignificant; earlier pregnancy antenatal visit rate of Control Group was higher that that of Intervention Group II. Intervention did not get the expected result.Conclusions: The antenatal visit coverage rate, median times of antenatal visit and median time of first antenatal visit were all achieved the A-level rural area standard according to the National Health Bureau. The earlier pregnancy antenatal visit rate was a little higher than the proportion from the report of the Third Time National Health Service Survey Analysis. But the five times or higher antenatal visit rate was less than 80% according to the Health Bureau. To improve care service utilization, we should begin from the primary level. We ought to improve the educational level of rural population; promote the traffic condition of remote areas; meanwhile, spread the advantages of NCMS for more people participation. After the intervention, the antenatal health service utilization rates in intervention groups were not higher than that of control group. The intervention failed. However, it was not the problem of the intervention alone, but the matter of interventional design and implementation. The failure at present can provide reference for the future interventions.