Study On The Demand And Utilization Of Maternal Health Care For Childbearingage Women In Poverty Areas

Objective:To understand the demand and utilization situation of maternal health services for women of childbearing age in Yudu County,and to analyze some influential factors on the both two based on the Anderson Healthcare Service Utilization Behavior Model(hereinafter referred to as “Anderson Model”),proposing its improvement of the utilization of health services for those women in poverty areas.Suggestions on enhancing the accessibility of maternal health services and health conditions of pregnant women are provided,thus giving references for improving the situation and related health policies during woman maternal period in other regions.Methods:According to the Anderson model,a theoretical framework for this research was constructed,and Questionnaires for the Demand and Utilization of Maternal Health Services for Women of Childbearing Age in Yudu County was compiled.Taking a simple random sampling method to carry out the questionnaire survey for the women of childbearing age(15-49 years old)in Yudu County,descriptive analysis,chi-square test and Logistic regression approach were taken to describe the demand and utilization of the services from three dimensions: propensity characteristics,ability factors and demand factors,analyzing its relevant influential factors.Results:(1)Basic informationA total of 740 pregnant women's data information were collected in the survey,including 347 pregnant women in rural households registration and 393 pregnant women in urban households registration.Among the 740 pregnant women,there are 33 poverty pregnant women,48 over 35 years old,and there are 218 pregnant women experienced three or more deliveries and more than 50% of them are in junior school education level.40.7% of the pregnant women think that health care during their pregnancy is very necessary.(2)Demand of health services for maternal womenIn the self-reported health,44.2% of the maternal women believed that they were in good physical health,and none of them thought they were in poor health.The proportion of high-risk pregnant women was 11.5%,and 6.8% of them had complications and comorbidities in pregnancy.Among them,pregnant women over 35 years old had the highest incidence of high-risk maternal rate and pregnancy complications and comorbidities.The two rates among the women in city household registration were both higher than those in rural household registration.Logistic regression analysis showed that the factors affecting the high-risk pregnant women were age and employment in the propensity characteristic dimension,and that affecting the prevalence of complications and comorbidities in pregnancy was the educational level in the propensity characteristic dimension(p<0.05).(3)Utilization of maternal health servicesA survey for the utilization of maternal health services showed the utilization rate of early pregnancy checkup services was 86.4%,the utilization rate of early pregnancy card services was 87.3%,the utilization rate of high-risk screening services was 87%,and the utilization rate of ?5 prenatal services was 91.9%,the utilization rate of HIV testing services was 94.9%,the utilization rate of syphilis virus testing services was 94.5%,the utilization rate of hepatitis B virus surface antigen testing services was 95.5%,and the utilization rate of prenatal screening services was 78.8%,and the utilization rate of other maternal health services was 4.1%.It can be found that ?5 prenatal screening services and HIV,syphilis,and hepatitis B virus testing services had a high utilization rate of more than 90%,and the remaining maternal health service utilization rates didn't reach the 90% standard,of which prenatal screening service utilization rate and other maternal health service utilization rate were lower.Logistic regression analysis presented that the common influencing factors of various maternal health services include the household registration and women's attitudes to maternal health services in the propensity characteristic dimension,the traffic time to service agencies in the ability factor dimension(p<0.05).The utilization rate of antenatal screening services and other maternal health care services is relatively low.In terms of prenatal screening services,statistically significant variables include household registration and women's attitudes to maternal health care,the delivery times in the propensity characteristic dimension,the average annual income of the family in the ability factor dimension and whether they are high-risk pregnant women(p<0.05)in the demand factor dimension.Besides,only the attitude to health services during pregnancy(p<0.05)affecting other maternal women's health care is statistically significant in the propensity characteristic dimension.The service utilization rate of ?5 prenatal check-ups and HIV,syphilis,hepatitis B virus tests was high.The factors that affect the service utilization are not just household registration,attitudes to health services during pregnancy and childbirth,and traffic time to service agencies,but the education level in the propensity characteristic dimension(p<0.05).What affects the utilization of HIV,syphilis,and hepatitis B virus testing services is self-reported health in the demand factor dimension(p<0.05).Conclusion:Medical security policies have relieved the financial burden of poverty pregnant woman to a certain extent.The maternal health care demand for high-age pregnant woman is even bigger.We find that there is a big difference in service utilization between basic inspection items and recommended inspection items.In order to improve the utilization of maternal health care and the health status for childbearing-age women in poverty areas,it is necessary to improve medical security system and childbearingage women's maternal health care system,strengthen obstetric services capacity building of primary health institutions,and improve childbearing-age women's health literacy and individual health consciousness.