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New Mothers' Survey in 2008 in rural China A CHIMACA report

Klemetti, Reija, Regushevskaya, Elena, Zhang, Wei-Hong, Raven, Joanna ORCID:, Long, Qian, Huang, Kun, Shen, Yuan, Wu, Zhuochun and Hemminki, Elina (2010) New Mothers' Survey in 2008 in rural China A CHIMACA report. Project Report. National Institute for Health and Welfare, Helsinki.

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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.
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.
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.
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.

Item Type: Monograph (Project Report)
Additional Information: Full text can be found on the National Institute for Health and Welfare, Finland website at ISBN 978-952-245-292-4 (pdf)
Uncontrolled Keywords: use of maternity care experiences of maternity care patient views pregnancy delivery prenatal care postnatal care rural China CHIMACA project
Subjects: W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 85 Patients. Attitude and compliance
WA Public Health > WA 20.5 Research (General)
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WQ Obstetrics > Childbirth. Prenatal Care > WQ 175 Prenatal care
WQ Obstetrics > Pregnancy > WQ 200 General works
WQ Obstetrics > WQ 500 Postnatal care
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Depositing User: Faye Moody
Date Deposited: 14 Feb 2012 15:18
Last Modified: 15 Dec 2021 12:39


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