New Mothers' Survey in 2008 in rural China | ICRH

Authors and affiliation: 

Wei-Hong Zhang - University Ghent / ICRH Reija Klemetti Elena Regushevskaya Joanna Raven Qian Long Kun Huang Yuan Shen Zhuochun Wu Elina Hemminki

Team members: 

Dr. Wei-hong Zhang;

Published: 

University Print Helsinki 2010

Publication Date: 

01/01/2010

Reija Klemetti, Elena Regushevskaya, Wei-Hong Zhang, Joanna Raven, Qian Long,

Kun Huang, Yuan Shen, Zhuochun Wu, Elina Hemminki. New mothers’ survey in

2008 in rural China. A CHIMACA report. National Institute for Health and Welfare

(THL), Report 23/2010. 125 pages. Helsinki 2010.

ISBN 978-952-245-291-7 (printed), ISBN 978-952-245-292-4 (pdf)

 

Introduction This report describes the methods and presents the basic results of the

new mothers' survey in rural areas in three Chinese provinces; Anhui, Chongqing

and Shaan’xi, conducted in 2008. The survey was one of several tools to evaluate

the impact of the interventions implemented by the CHIMACA project -“Structural

hinders to and promoters of good maternal care in rural China” - in 2007-2008.

 

Aims The aims of the whole CHIMACA project were to strengthen and improve the

performance of health care system in rural China in order to alleviate financial

access and improve quality of maternal care and to encourage research collaboration

between European and Chinese researchers and students. The aims of the new

mothers' survey were to collect data on the use of maternal health care, hinders in

using care, content of and satisfaction with the received care and to measure the

impact of the interventions carried out. The aim of this report is to give basic

descriptive results by province.

 

Methods In each province, one or two poor counties and all townships from the

selected counties, in total 104 counties, were selected. For the cluster randomized

trial the townships in the selected counties were randomized for various

interventions. After the interventions were implemented, this cross-sectional survey

in selected villages in these townships was made. Villages were selected by distance

to the nearest township hospital and population size.

Data were collected by interviewing women using a structured questionnaire

prepared by an international group of researchers from Finland, Belgium, United

Kingdom, Sweden, and China. If the woman was not available to answer the

questions, a relative (husband, mother or mother-in law) was interviewed using an

abbreviated questionnaire. The questionnaire included questions related to the

woman’s and her partner’s background, family’s situation, earlier pregnancies, index

child and pregnancy and use and experiences of prenatal, delivery and postnatal

care.

 

Results Overall, 3673 women and 285 relatives were interviewed giving the

response rate 71%; 68% in Anhui and Chongqing and 76% in Shaan’xi. The main

reasons for non-response was that women were not reached: working outside the

area (migrant women), visiting relatives, or living with mother's relatives (which is

typical in rural China after having given birth).

Of the interviewed, 15% were migrants and the proportion was almost the same

in all three provinces. One-fifth of the women reported the pregnancy to be illegal

(unauthorized by family planning authorities). Half of the women had stopped

working completely during pregnancy, often already in early pregnancy. Almost all

women had prenatal visits which were mostly paid out of pocket. About half of the

women gave birth at the county or higher level hospital. Over 40% of women did

not receive any reimbursement for delivery costs. Homebirths were uncommon.

Caesarean section was almost as common as a vaginal birth. One-third of the

decisions for Caesarean sections were made during pregnancy and half just before

the delivery. Overall, only 44% of women had had postnatal visits.

Most results were similar in the three provinces. The differences include: in

Anhui the proportion of illegal pregnancies was lower than in Chongqing and

Shaan'xi. In Chongqing the time to get from home to village clinic was longer than

in the other two provinces. In Shaan'xi the proportion of those women who stopped

working completely during pregnancy was lowest. The highest Caesarean section

rate was in Anhui. In Shaan'xi more women delivered at county or higher level

hospital than in Anhui and Chongqing, where women mostly delivered at township

hospital. In Anhui the proportion of women without postnatal visits was higher than

in other two provinces.