Study On Equity Of Maternal Health Services Utilization In China

Objectives Focusing on large differences between urban and rural maternalmortality rate, the study aimed to evaluate the equity of maternal health servicesutilization from the social economy and cultural dimension, combining managementand supplier multidimensional perspective. The study wanted to discover existingproblems, and then propose strategies and suggestions to improve maternal healthservices utilization and its equity. The research contents included:1.To constructcomprehensive evaluation index of maternal health care services utilization;2.Todescribe the maternal health services utilization;3.To calculate the equity of maternalhealth services utilization.4. To put forward countermeasures and suggestions toimprove maternal health services utilization and its equity.Methods Data sources: Using multi-stage random sampling method, accordingto the regional characteristic, three provinces, Shandong, Gansu, and Henan wereselected. In every province we chose three cities, then mothers whose baby42daysto six-month old were interviewed.2021questionnaires were distributed, a total of1997copies were returned, the return rate was98.81%.1945questionnaires werevalid, the effective rate was97.40%.Data analysis: SPSS13.0and Excel2003software were used for data processing,chi-square test for single factor analysis, comprehensive evaluation index to measurematernal health services utilization, Gini coefficient and Lorenz curve to measureinequality of income distribution, range method, concentration curve andconcentration index to quantitative analysis of equality of maternal health service utilization.Results1.Rural maternal health care services utilization was lower than that ofthe city, inequity existed between urban and rural maternal health care utilization;Pre-pregnancy health service utilization, maternal health care management card’scoverage rate, postpartum three visits rate were all low; Pregnancy check andhospital delivery rate were high.2. From each period, the investigation showed thatintrapartum health care got fully used; pregnancy health care utilization wasinadequacy, especially early pregnancy; while pre-pregnancy and postpartumutilization were serious inadequacy. From each stage of the equity of utilization,pre-pregnancy and early pregnancy had poor equity, intrapartum had optimal equity,and the utilizations of other stages were basically equal.3. Generally speaking, thebiggest issue of maternal health care services utilization was insufficient, andsecondly was inequity. According to income, maternal utilization rate of high-incomegroup was higher than that of the low-income, but the difference was not too big, allbelonged to low level. From cultural factor, maternal utilization rate of the highesteducation and the lowest differed42.6%, concentration index was also high; inequityof maternal health care utilization was mainly reflected in low education degree,showed that of education influence should get more attention.Conclusions1.Rural maternal health care services utilization should beimproved and the gap between urban and rural should be narrowed.2.To graduallyimprove maternal health care utilization and its equity in different stages anddifferent contents: First, to attach great importance to pre-pregnancy care, postpartumcare; Second, to further improve health care during pregnancy; Third, continue tomaintain the intrapartum health care.3. Pay attention to vulnerable groups’ maternalhealth services utilization and its equity: low income and low education are thedeep-seated reasons to cause health care utilization inequity. And low income andlow education level can’t be changed in a short time, so in the near future, thegovernment and health care institutions should adopt allowance, assistance,propaganda to ensure the utilization equity, at the same time, formulate long-termdevelopment strategy for economic and education developing to reduce the influence on health service utilization.4. From the service providers’ perspective: Firstly, toclear the function positioning of maternal and child health service system; Secondly,to ensure basic services and create characteristic service, strengthen interaction;Finally, to strengthen construction of maternal and children health care institution.