AimTo evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector.MethodsWe conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider.ResultsAlmost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals.ConclusionThe quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities.
The results of this study demonstrated a substantial decline in BLLs from 2004 to 2010 among Chinese children 0-6 years living in cities. However, these levels were higher than levels in countries, such as the USA, Canada, Japan and Sweden. These data demonstrate that Chinese children's lead exposure remains a public health problem that requires additional effort and resources.
We evaluated the relationship between child (aged 6-36 months) height and blood zinc, copper, iron, calcium, and magnesium concentrations. We selected 840 children following a physical examination. Weight and supine length or standing height were measured according to the World Health Organization guidelines. Polarographic analysis was used to measure zinc, copper, iron, magnesium, and calcium levels. Differences in heights between groups with low vs. high mineral concentrations, stratified by sex and age, were compared by analysis of variance. Relationships between these five elements and heights were tested by multiple regression analysis. Zinc levels in the shorter group (height for age (HAZ) ≤ -0.3) were 135.84 ± 39.76 and 134.83 ± 37.57 μmol/L in boys and girls, respectively. Zinc concentrations in the taller group (HAZ > -0.3) were 142.50 ± 35.85 and 140.52 ± 35.80 μmol/L in boys and girls, respectively. The difference between the two height groups in boys and girls was statistically significant. Compared with those (143.06 ± 33.76 μmol/L) in the taller group, zinc concentration (131.30 ± 40.75 μmol/L) in the shorter group was significantly lower (p = 0.04) at age 6-12 months. Height was positively correlated with zinc level in children aged 6-12 months (p < 0.05). Zinc levels were positively correlated with calcium, magnesium, and iron concentrations in children aged 6-36 months (p < 0.05). Our results indicated that zinc levels and height are correlated, and zinc levels were related to calcium, magnesium, copper, and iron concentrations. Therefore, to ensure healthy development in children, blood levels of these five elements should be balanced.
The adverse effects of lead on human especially childhood have been well established. Largely due to the phase out of lead in gasoline, blood lead levels (BLLs) had declined substantially all over the world including China. In 2004, 2007, 2010, and 2013, we conducted a continuous project including 47,346 children aged 0-6 years old from 11 cities all over China to show how the decline happened and to explore what to do next to improve the BLLs of children of China. Our data shown the BLLs of Chinese children decreased from 46.38, 43.58, 38.95 to 37.17 μg/L, but the decline was not enough. These decline was mainly because of the number decrease of children with high BLLs. Integrated strategy should be used to promote the BLLs of Chinese children, like striving to improve the environment, setting new cutoff for high BLLs, and establishing routine blood lead screening.
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