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Comparative Study
. 2017 Jul 20;18(1):39.
doi: 10.1186/s12889-017-4601-4.

Exploring status and determinants of prenatal and postnatal visits in western China: in the background of the new health system reform

Xiaojing Fan  1 , Zhongliang Zhou  2 , Shaonong Dang  1 , Yongjian Xu  2 , Jianmin Gao  3 , Zhiying Zhou  1 , Min Su  2 , Dan Wang  2 , Gang Chen  4
Affiliations
Comparative Study

Exploring status and determinants of prenatal and postnatal visits in western China: in the background of the new health system reform

Xiaojing Fan et al. BMC Public Health. .

Erratum in

  • Erratum to: BMC Public Health, Vol. 18.
    [No authors listed] [No authors listed] BMC Public Health. 2017 Sep 22;17(1):736. doi: 10.1186/s12889-017-4709-6. BMC Public Health. 2017. PMID: 28938882 Free PMC article. No abstract available.

Abstract

Background: Prenatal and postnatal visits are two effective interventions for protection and promotion of maternal health by reducing maternal mortality and improving the quality of birth. There is limited nationally representative data regarding the changes of prenatal and postnatal visits since the latest health system reform initiated in 2009 in Shaanxi, China. The aim of this study was to explore the current status and determinants of prenatal and postnatal visits in the background of new health system reform.

Methods: Data were drawn from two waves of National Health Service Surveys in Shaanxi Province which were conducted prior and post the health system reform in 2008 and 2013, respectively. A concentration index was employed to measure the degree of income-related inequality of maternal health services utilization. Multilevel mix-effects logistic regressions were applied to study the factors associated with prenatal and postnatal visits.

Results: The study sample consists of 2398 women aged 15-49 years old. The data of the 5th National Health Services Survey in 2013 showed in the criterion of the World Health Organization (WHO), the percentage of women receiving ≥4 prenatal visits was 84.79% for urban women and 82.20% for rural women, with women receiving ≥3 postnatal visits were 26.48 and 25.29% for urban and rural women respectively. In the criterion of China's ≥ 5 prenatal visits the percentages were 72.25% for urban women and 70.33% for rural women; 61.69% of urban women and 71.50% of rural women received ≥1 postnatal visits. As for urban women, the concentration index of postnatal visit utilization was -0.075 (95% CI:-0.148, -0.020) after the health system reform. The determinants related to prenatal and postnatal visits were the change of reform, women's education, parity and the delivery institution.

Conclusions: This study showed the utilization of prenatal and postnatal visits met the requirement of the WHO, higher than other areas in China and other developing countries after the new health system reform. The new health system reform increased the utilization of postnatal visits in poor urban women and improved the frequency of prenatal and postnatal visits in rural women.

Keywords: Health system reform; Inequality; Postnatal visits; Prenatal visits.

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Conflict of interest statement

Ethics approval and consent to participate

In this study verbal informed consent was obtained by surveyors from each participant before the investigation. In order to get the cooperation from the sample counties, the Shaanxi Health and Family Planning Commission delivered a document, and guiders from the sample counties would contact each participant who agreed to accept the interview, and make an appointment with them. The investigators then went to the participants’ house and collected information in our questionnaire, which means if we have the participant’s questionnaire, we have got the participant’ consent. This method of consent in our study was approved by the Ethics Committee of Xi’an Jiaotong University Health Science Center (4th NHSS Approval No. 2014-204 and 5th NHSS Approval No. 2015-644), and it conformed to the ethics guidelines of the Declaration of Helsinki.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Comparisons on prenatal and postnatal visits before and after health reform
See this image and copyright information in PMC

References

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