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Utilisation of maternal health care in western rural China under a new rural health insurance system (New Co-operative Medical System)

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Long, Qian, Zhang, Tuohong, Xu, Ling, Tang, Shenglan and Hemminki, Elina (2010) 'Utilisation of maternal health care in western rural China under a new rural health insurance system (New Co-operative Medical System)'. Tropical Medicine & International Health, Vol 15, Issue 10, pp. 1210-1217.

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Abstract

METHODS: Data from cross-sectional household-based health surveys carried out in ten western rural provinces of China in 2003 and 2008 were used in the study. The study population comprised women giving birth in 2002 or 2007, with 917 and 809 births, respectively. Correlations between outcomes and explanatory variables were studied by logistic regression models and a log-linear model.

RESULTS: Between 2002 and 2007, having no any pre-natal visit decreased from 25% to 12% (difference 13%, 95% CI 10-17%); facility-based delivery increased from 45% to 80% (difference 35%, 95% CI 29-37%); and differences in using pre-natal and delivery care between the income groups narrowed. In a logistic regression analysis, women with lower education, from minority groups, or high parity were less likely to use pre-natal and delivery care in 2007. The expenditure for facility-based delivery increased over the period, but the out-of-pocket expenditure for delivery as a percentage of the annual household income decreased. In 2007, it was 14% in the low-income group. NCMS participation was found positively correlated with lower out-of-pocket expenditure for facility-based delivery (coefficient -1.14 P < 0.05) in 2007.

CONCLUSIONS: Facility-based delivery greatly increased between 2002 and 2007, coinciding with the introduction of the NCMS. The rural poor were still facing substantial payment for facility-based delivery, although NCMS participation reduced the out-of-pocket expenditure on average.

Item Type: Article
Subjects: WA Public Health > WA 100 General works
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
Digital Object Identifer (DOI): https://doi.org/10.1111/j.1365-3156.2010.02602.x.
Depositing User: Faye Moody
Date Deposited: 24 Aug 2011 13:15
Last Modified: 11 May 2018 08:56
URI: https://archive.lstmed.ac.uk/id/eprint/1717

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