Research On Prenatal Care Service Access And Its Influencing Factors In X Province

Objective:Through the sampling of 590 pregnant women in six hospitals in X Province,the data of the province and the analysis of the access to prenatal care for demand side services in urban and rural areas were analyzed,and the influencing factors of prenatal care services were analyzed.In order to provide effective ways for health care planners and medical professionals to improve maternal health care.Methods: 1.Literacy study: Using "Prenatal care","Andersen's behavioral model" as key words in domestic and international database of access to prenatal care services factors related to the literature and analysis.2.Questionnaire survey: Reference to domestic and foreign family health questionnaire,after consultation with the Global Health Center experts to design we use Andersen health service behavioral model as the framework of the "women's prenatal care survey" random sampling of 590 urban and rural pregnant women.3.Statistical analysis: Using Epidata3.1 software for questionnaire entry,using descriptive study(mean,composition ratio,histogram),chi-square test,T-test and univariate analysis and multivariate logistic regression to do statistical analysis.Results: 1.Official data results: Maternal system management rate in X Province in recent three years was gradually emerged in declining trend,cesarean section number of live births,the number of high-risk mothers,maternal deaths and confirmed numbers of prenatal diagnosis demonstrated a rising trend.The access to prenatal care in urban women in X Province is higher than that in rural women,and the differences between urban and rural areas are significant.2.Questionnaire survey results: In addition to non-qualified questionnaires,the study included 590 people for statistical analysis.The number of prenatal care check-ups in urban areas was higher than that in rural areas.The difference of prenatal care access between urban and rural women was significant. The number of prenatal examination items was more than that of rural areas,and the differences were statistically significant.(1)Univariate analysis showed that factors affecting the access to prenatal check-ups including educational level of maternal and their spouse,total annual family income,number of pregnancies,timing of first production inspection,prenatal examination costs,delivery place,the importance of prenatal care,self-weight monitoring during pregnancy,prescribed medication,moderate daily exercise and taking initiative to obtain health knowledge,the necessity of pregnancy,the time of birth inspection,timing of first birth inspection,the cost of medical examination,location,the importance of prenatal care,self-weight monitoring during pregnancy,prescribed medication,adequate amount of daily exercise,taking initiative to obtain health knowledge.Factors affecting rural women's access to prenatal care include the educational level of maternal and their spouse,maternal history,whether to participate in prenatal care,prenatal care service satisfaction,prenatal healthcare education needs,medical expenses,communication situation,past history,place of delivery,family attention to prenatal care,township hospitals to provide prenatal care knowledge,distance and time from the prenatal care institutions to place of residence,maternal behavior,health self-assessment and clinical assessment,external environment and so on.(2)Logistic regression analysis showed that urban women had the necessity of producing seizures,the cost of medical examination,and the inclusion of medical examinations in the period of pregnancy.The rural women's education level,occupation,spouse occupation,pregnancy time,the necessity of production check,past history,medical expenses,medical and patient communication,Satisfaction with prenatal care services,that the importance of prenatal care,pregnancy compliance test,waiting time into the regression equation.Conclusion: 1.According to prenatal care standard established by China Health Family Planning Commission,the level of access to prenatal care of women in X Province is not high,and the difference of prenatal care between urban and rural women is significant.2.The influencing factors of access to prenatal care of urban and rural women in X Province are complex.According to the sub-module of population characteristic in Andersen health service utilization behavioral model,the dominant factors are as follows:(1)Urban dominant factors: maternal and her husband's education level(junior high school and below),pregnancy prescribed medical examination,that there is a need for birth inspection and prenatal care costs(more than 6,000 yuan)(2)the leading factors in rural areas: maternal education level(Junior high school and below),her husband's education level(college / high technology),prenatal examination costs(0-3000 yuan),that is necessary to check the production,asked all past history,pregnancy counseling,medical and patient communication is particularly smooth And most of the smooth,that prenatal care is not important,term gestational age,pregnancy times(ref: twice).(3)Focusing on low access to prenatal care groups,strengthening the construction of prenatal care institutions,increasing women's prenatal care education level,from macro and micro,supply and demand perspective to improve the access to prenatal care services in X Province.