You Hua, Yu Ting, Gu Hai, Kou Yun, Xu Xin-Peng, Li Xiao-Lu, Cui Nan, Bai Lan
1 Nanjing Medical University, China.
2 Nanjing University, China.
Inquiry. 2019 Jan-Dec;56:46958019865435. doi: 10.1177/0046958019865435.
With relatively sufficient antenatal health service supplies in eastern rural China, the utilization still needs to be improved. The objective of this study was to identify factors that correlate with antenatal care (ANC) utilization from the demand-side in Jiangsu, China. In a cross-sectional survey, a sample of 896 rural women who had a childbearing history in the previous 5 years answered ANC questions and formed the final analysis. Questionnaire was designed based on Andersen's behavioral model. The outcome variables included receiving times and items of prescribed ANC utilization, and the explanatory variables were organized into 3 hierarchical levels: predisposing, enabling, and need factors. Univariate analysis and multivariate logistic regression analysis were conducted. In the results of multivariate logistic regression, factors significantly associated with ANC examination times included income, odds ratio (OR) (95% confidence interval [CI]) = 2.90 (1.92-4.39); the distance from the nearest hospital, OR (95% CI) = 0.67 (0.47-0.95); chronic disease, OR (95% CI) = 1.77 (1.15-2.72); and parity, OR (95% CI) = 0.66 (0.46-0.95), while factors significantly associated with ANC examination items included education, OR (95% CI) = 8.02 (1.08-59.67); income, OR (95% CI) = 3.90 (1.72-8.85); female medical staff in towns and villages, OR (95% CI) = 2.64 (1.39-5.02); and parity, OR (95% CI) = 0.41 (0.23-0.75). In reducing inadequate ANC utilization in rural area, efforts should be made not only to target the rural women with lower income, lower educational level, and multi-parity, but also to further improve the accessibility of the primary medical facilities and female staff at the grassroots level.
在中国东部农村地区，虽然产前保健服务供应相对充足，但利用率仍有待提高。本研究的目的是从需求侧识别与中国江苏省产前保健（ANC）利用率相关的因素。在一项横断面调查中，抽取了896名在过去5年中有生育史的农村妇女作为样本，她们回答了有关产前保健的问题并纳入最终分析。问卷是根据安德森行为模型设计的。结果变量包括产前保健规定利用率的接受次数和项目，解释变量分为3个层次水平：易患因素、促成因素和需求因素。进行了单因素分析和多因素逻辑回归分析。在多因素逻辑回归结果中，与产前检查次数显著相关的因素包括收入，比值比（OR）（95%置信区间[CI]）=2.90（1.92 - 4.39）；与最近医院的距离，OR（95%CI）=0.67（0.47 - 0.95）；慢性病，OR（95%CI）=1.77（1.15 - 2.72）；以及产次，OR（95%CI）=0.66（0.46 - 0.95），而与产前检查项目显著相关的因素包括教育程度，OR（95%CI）=8.02（1.08 - 59.67）；收入，OR（95%CI）=3.90（1.72 - 8.85）；乡镇女医务人员，OR（95%CI）=2.64（1.39 - 5.02）；以及产次，OR（95%CI）=0.41（0.23 - 0.75）。为了减少农村地区产前保健利用率不足的情况，不仅应针对低收入、低教育水平和多产次的农村妇女，还应进一步提高基层医疗设施和基层女性工作人员的可及性。
