| BackgroundWomen are creators of material and spiritual civilization, it is an important force of social development and progress as same as men. Women’s health relates to family happiness and society stability. However, due to the physiological specificity, women were regarded as vulnerable groups, their health has been a special concern of the whole society. As a special period of woman’s life, maternal health care relates to two generations health directly, it needs more high-level special care. With the full implementation of the policy of second-children, the pregnant health status and the level of maternal health services is bound to get more attention. In recent years, maternal health care has been made considerable development in our country, but there are still many problems because of various limits, for example the maternal health services differences between urban and rural areas and different regions. Studies have shown that the women’s maternal health services utilization in eastern region is higher than the western region, rural areas is far less than urban areas. Meanwhile, the factors of maternal health service utilization have also changed. But these discussions or study existed a few years ago, they were about national or restricted in certain cities, there has been little research on Shandong Province up to now. Therefore, this paper choose 2013 Health Service Survey data in Shandong Province as the research data, studies on the utilization and its influencing factors of maternal health care services throughout urban and rural areas in Shandong Province, and then provides the basis for improving the level of maternal health care.ObjectThe aim of the paper is to know the maternal health care services in Shandong province include the utilization status of prenatal, intrapartum and postnatal, to analyze the factors of maternal health care services utilization. To explore effective measures to improve maternal health care services utilization and then improve the maternal health.Data and MethodUsing a stratified multi-stage cluster sampling method, the residents from the 17 cities, 20 counties (cities, districts),100 townships (streets),200 villages of the province were surveyed in home. Finally 1446 women were chosen as study objects who gave birth after August 15,2008. These women were surveyed by the questionnaire for women aged 15-64 years and family members personal information. Epi-Data3.02 Software are used input date, using Excel software check data and using SPSS20.0 software to analyze data.Results1. Prenatal health care:The rate of prenatal examinations was 98.4%, of which 73.5% had more than 5 examinations, the average number of examinations (6.1 ± 2.8) times. Four projects examination rate in more than 90%, which is ultrasound wave, blood pressure, urinalysis and blood examination, the rate in urban areas is higher than rural areas. The factors of more than 5 examinations were maternal education level, frequency of delivery, age of husband, distance to the nearest medical institution and the urban and rural geographical.2. Intrapartum health care:On the birth place, the rate of hospital delivery is 97.7%, 65.6% of the 1446 women birthed in county hospital and municipal hospitals,22.8% in MCH organization. On the mode of delivery, vaginal birth delivery rate was 51.2%, cesarean 48.9%. On delivery costs, the average hospital delivery cost 3888, with an average of 2854 pay their own, the non-hospital delivery 3098, with 2329 pay their own, the vaginal birth costs2723, with 2329 pay their own, cesarean 5067, with 3767 pay their own. The factors of hospital delivery were frequency of delivery, the husband occupation, urban and regional differences. The factors of cesarean were maternal occupation, frequency of delivery, household income and urban and regional differences.3. Postnatal health care:the rate of postnatal visit is 56.1%, there were 162 people had received more than 3 times postpartum visits among 1446 women, accounting for 11.2%.1318 women selected breastfeeding, taking up 91.2%, breastfeeding completely lasts 5.6 months. Household income affected postpartum visits.4. Utilization of maternal health care in different areas:the rate of more than 5 times prenatal exams, hospital delivery, cesarean is the highest in eastern, except 3 times postpartum visits. For the rate of more than 5 times prenatal exams, eastern region had highest imbalance, the central region lowest. For the rate of hospital delivery, western region had highest imbalance. For the rate of 3 times postpartum visits, eastern region had highest imbalance, the western region lowest.Conclusions and SuggestionsThe degree of utilization of maternal health care in Shandong Province urban and rural areas need further improvement, especially to pay more attention to postnatal care services. The factors of maternal health care services utilization include maternal education level, frequency of delivery, the husband of age, and distance to the nearest medical institutions as well as the urban-rural divide, husband occupation, household income. There is imbalance in different regions about maternal health care utilization. Therefore, we should emphasize on health education; strengthen the maternal service management of rural areas, narrowing the gap between urban and rural areas; improve the accessibility and balance of maternal health services targeted and sub-projected, strengthen the government’s responsibility to provide more benefits policy to maternal health; efforts to explore one kind of maternal health care mode for Shandong province. |
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