Study On Equity Of Maternal Health Service Utilization In Rural Areas Of Ningxia

Objective To discribe the current status and equity of maternal health service utilization in rural areas of Ningxia;Analyzing the main factors of equity of maternal health services utilization in rural areas;Evaluating the effect of implementation of Ningxia's maternal and child health policy on improving equity of maternal health service utilization.;To put forward relevant policy Suggestions to improve maternal health services utilization and its equity.Methods Sample households were sampled by multi-stage stratified random sampling.Questionnaire surveys on women of childbearing age who had brought children during the past year in sample households in five counties of Ningxia in 2009,2012 and2015.The contents of the survey include:(1)basic personal information(2)utilization of maternal health services: prenatal examination,delivery,postpartum visit,gynecological examination,etc.(3)family economic situation.Results 1.The average maternal ages of rural residents in the years of 09,12 and 15were(28.29±4.15)years old,(26.08±4.46)years old,and(26.65±6.40)years old;The ratio of hui han nationality is 1.86:1,2.36:1,2.88:1;The educational level of the survey population is relatively low,and the occupation is mainly farmers;The coverage rate of medical insurance in the year of 09,12 and 15 is higher and increasing year by year(P=0.006),but the insurance coverage was relatively single,and the NCMS was the main.2.Rural maternal health services utilization status: The gynecologic examinationrate,early pregnancy check rate,prenatal examination rate,hospital delivery rate and postpartum visit rate are increasing year by year,but only 51.24% of the maternal had 5 or more inspections,and 58.60% of the total production and inspection items;the reasons for the absence of hospital deliveries in 2009 were urgent production and economic difficulties(34.44%,31.99%),and in 2012 and 2015 were immediate production(61.29%,56.25%).3.Multivariate Logistic regression analysis showed that prenatal and postnatal health service utilization factors are basically the same,and age,ethnicity,educational level and income are the influencing factors of maternal health service utilization.4.The equity of maternal health service utilization in rural areas:In 2009,2011 and2015 years,the CI and ID of rural maternal between different income groups had positive values in their gynecologic examination,early pregnancy check,prenatal examination,hospital delivery and postpartum visit,the use of health services tends to favour the rich.Both the CI and ID are within 0.2,which indicate that the health service utilization equity is in good condition;In 2009,12 and 15 years,the value of the CI and ID of rural maternal postpartum visits increased year by year,which explain that the equity of postpartum visits gradually decreases;The CI and ID of the other indexes is decreased which indicates that the equity of the other indicators gradually improved.5.The influence factors of the equity of rural maternal health service utilization:Economic income is the first contributing factor to increase the inequality of health service utilization.The degree of education and the ethnicity increase the inequality of health service to some exten.Participating in medical insurance is the main factor to reduce the inequality of health service utilization.Conclusion 1.The implementation of maternal and child health policy in Ningxia has promoted the utilization of rural maternal health services,but there is still a certain gap compared with the regional average level.The utilization of health service in each stage is different,the utilization rate of hospital delivery is high,but the utilization rate of gynecologicexamination,prenatal examination and postpartum visit is low.2.The elderly,Hui nationality,low economic income and low education level are the main factors that restricting the rural maternal health services utilization.3.The rural maternal health service utilization in Ningxia is fair,and the implementation of maternal and child health policy further improves the fairness of health services.The fairness of the health services utilization between different stages is different.The fairness of hospital delivery and early pregnancy examination is relatively good,but the gynecological examination and prenatal examination is poor.4.Economic income is the first contributing factor to increase the inequality of health service utilization,followed by education levels and ethnic groups.Participating in medical insurance can reduce the inequality of health service utilization.