| Objective: This study is to understand maternal health service needs andutilization status, and to explore the main factors affecting the utilization of maternalhealth services, then propose the strategy and policy recommendation to increase theutilization of maternal health sercices, so that we can achieve the purpose ofpromotion of maternal health services and improving the level of maternal health.Methods: Adopting a multi-stage random sampling method, according to theregion in the country, we choosed three provinces of Shandong, Henan and Gansu,then randomly selected three prefecture-level cities in each province in accordancewith the level of economic development, and lastly investigated2021women whohad given birth between July and September in2009in EPI vaccination area with aself designed questionnaire.All subjects should be investigated with the uniform questionnaire.Questionnaire is filled by the trained research team according to the actual situation.The questionnaire mainly includes the basic situation of maternal,such as age,educational level, occupation, residence, spouse status, production experience, etc,and the status of all periods of health care demand and utilization of maternal,covering pregnancy period, during pregnancy period, intrapartum period andpostnatal period.After the investigation, SPSS13.0is used to establish a database, data entry andanalysis. Make statistical description of the status of maternal health servicesutilization, univariate analysis of possible influencing factors, and finally, multiple logistic regression analysis of the single factor test which were statisticallysignificant variables.Results: We distributed2021copies, and1997copies were recovery. Therecovery rate was98.81%. The number of valid questionnaires is1945, and validresponse rate is97.40%. A total of1945cases of maternal were investigated,including Gansu province,681cases (35.01%), Henan province,581cases (29.87%),and Shandong province,683cases (35.12%).976maternal (50.18%) live in the city,and969maternal (49.82%) live in rural areas. Their ages are between17and45, andaverage age is (26.88±4.15) years old. Their education level is as follows,202cases(10.39%) of primary school and below,713cases (36.66%) of junior high schooleducation,617cases (31.72%) of high school or secondary school education level,370cases (19.02%) of university or college education,43cases (2.21%) of graduatestudents and higher education. Annual household income rangs from3500yuan to480,000yuan, of which, annual income of the average household in rural is23976.60±25980.78yuan, and that in urban, the average household annual income is32585.69±18654.44yuan. Medical costs are paid for mainly through the new ruralcooperative medical care and personal income. The distance of most maternal (1022cases, accounting for52.54%) to the sector which can provide maternal health careservices is less than5kilometers.The creating rate of systemic health management cards in early pregnancyperiod is49.77%, health guidance rate is82.98%in prenatal period, and52.75%inpostnatal period, rate of prenatal check is99.33%,5times rate of prenatal check is74.24%, rate of hospital delivery is98.61%, rate of postpartum visit is42.21%,3times rate of postpartum visit is9.51%.Univariate analysis and multivariate analysis showed that the major influencingfactors are age, job, education, distance to medical institution, number of children,place of residence, marital status, and so on.Conclusions: The first time of receiving the prenatal care is later, the utilizationof preconception care services is influenced by various factors, and the rate ofpostpartum visit is lower, so maternal health services need to be strengthened. Government, agencies related to maternal and child health, maternal and theirfamilies should explore health education and health promotion measures based on itsinfluential factors, and try everyone’s best to improve maternal health literacy andhealth services utilization. |
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