Challenges to maternal health care utilization among ethnic minority women in a resource-poor region of Sichuan Province, China

Abstract

We present a simple descriptive study of maternal health care utilization among ethnic minority women in a remote region of China. Factors that affect women obtaining care and their decision-making are explored. Results show that utilization of maternal health care services is associated with a range of social, economic, cultural and geographic factors as well as the policies of the state and the delivery of services. Utilization is not necessarily increased through easy access to a health facility. We identify potential for improving utilization through developing the role of village-based health care workers, expanding mobile antenatal care clinics and changing the way township hospital services are provided and funded. This would include modifications to rural health insurance schemes. Several of these changes are achievable at the township or county level. The findings of this study provide insights that can be used by local health providers, planners and decision-makers to improve the provision of maternal health care services to ethnic minority women.

Availability and quality of emergency obstetric care in Shanxi Province, China

“…Our study in Sichuan and Shanxi Provinces found that most doctors and midwives had had no in-service training for many years [11,26]. In-service training is an effective way for local staff to keep their knowledge and skills up to date.…”

Socioeconomic inequalities in hospital births in China between 1988 and 2008

“…Women in remote areas travel long distances to reach a hospital, but smaller township hospitals in these areas may be poorly equipped for deliveries. 30,31 The absence of caesarean section and blood transfusion in some of these hospitals may deter women from delivering there. 30 Some evidence also suggests that women in the most remote counties, particularly those from ethnic minorities, are reluctant to deliver in hospital because of the discomfort and embarrassment associated with modern birthing practices.…”

“…30 Some evidence also suggests that women in the most remote counties, particularly those from ethnic minorities, are reluctant to deliver in hospital because of the discomfort and embarrassment associated with modern birthing practices. [31][32][33] According to many studies, inability to pay is one of the main obstacles to the uptake of maternity care in China, especially among poor rural households. 10,15,18,34 Our analysis suggests that inequalities between socioeconomic regions are more pronounced than between individual households.…”

“…It did not show household income to be an important determinant of hospital delivery, since the gap between high-and low-income households has nearly disappeared. The NCMS, which had achieved nearly universal coverage by 2007, 24 may have reduced the financial barriers affecting 18,31 and the mean out-of-pocket expenditure reported for institutional births among low-income groups in western rural China is still a substantial burden for the poor in the most remote regions. 18,35 Most families now probably recognize the need to give birth in hospital and are willing to bear the additional costs involved.…”

Barriers to Hospital Deliveries among Ethnic Minority Women with Religious Beliefs in China: A Descriptive Study Using Interviews and Survey Data

“…There are numerous factors affecting the utilization of maternal care including maternal, family and social factors, policy interventions, and health facility factors [18,19,20]. While there are studies analyzed the demanding factors [3,21], understanding remains limited for social and provision factors.…”