TY - JOUR
T1 - What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis
AU - Liu, Bo
AU - Shi, Duorui
AU - Wang, Wei
AU - Nan, Lei
AU - Yin, Bibo
AU - Wei, Chongyi
AU - Emu, Aga
AU - Zhou, Haiqun
AU - Wazha, Wuha
AU - Zhu, Jianming
AU - Wang, Shumei
AU - Ma, Wei
N1 - Funding Information: Funding This study was funded by the Alliance for Health Policy and Systems Research, WHO, Geneva with support from the Norwegian Government Agency for Development Cooperation (Norad), the Swedish International Development Cooperation Agency (Sida) and the UK Department for International Development (DFID). The technical coordination and support was provided by the Department of Maternal Newborn Child and Adolescent Health, WHO Geneva. Competing interests None declared. Patient consent for publication Not required. Publisher Copyright: © 2019 Author(s).
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Background Mother-to-child transmission (MTCT) is one of the main transmission routes of HIV, and the probability of MTCT can be dramatically reduced with comprehensive interventions. In southwest and western regions in China, the level of development in rural areas is relatively backwards and retains some original features, which also increases the difficulty of controlling infectious diseases. The Liangshan Prefecture started the prevention of MTCT programme in 2009. However, the implementation of the programme is not ideal, and the coverage of HIV testing is still low. Many Yi (local major ethnicity) women did not take antenatal care (ANC) and just gave birth to their babies at home for a variety of reasons. Methods Women with pregnancy history in the last 5 years were recruited from two townships based on cluster sampling. Face-to-face interviews were conducted to collect data. Descriptive analysis was performed to describe demographic characteristics, history of pregnancy and ANC uptake, knowledge of and attitudes towards ANC. Multivariable analysis was used to identify factors associated with uptake of ANC. Results Among 538 women who completed the questionnaires, 77.9% knew that ANC was necessary during and after pregnancy. However, only 24.2% actually accessed ANC. Almost all women (94.6%) expressed their willingness to receive ANC for pregnancy but barriers towards actual uptake of ANC existed including shyness, lack of independence and unavoidable cost. Multivariate analysis showed that no experience of living outside of Zhaojue for more than 6 months, higher number of births, not knowing the necessity of ANC during pregnancy and not knowing the government's promotion policies for ANC were associated with lack of ANC uptake. Conclusion Although ethnic minority women in rural Liangshan expressed strong intention to use ANC, actual uptake of ANC was low. Knowledge of ANC and HIV prevention for MTCT should be improved among this population, and efforts should be made to help them overcome barriers to accessing ANC.
AB - Background Mother-to-child transmission (MTCT) is one of the main transmission routes of HIV, and the probability of MTCT can be dramatically reduced with comprehensive interventions. In southwest and western regions in China, the level of development in rural areas is relatively backwards and retains some original features, which also increases the difficulty of controlling infectious diseases. The Liangshan Prefecture started the prevention of MTCT programme in 2009. However, the implementation of the programme is not ideal, and the coverage of HIV testing is still low. Many Yi (local major ethnicity) women did not take antenatal care (ANC) and just gave birth to their babies at home for a variety of reasons. Methods Women with pregnancy history in the last 5 years were recruited from two townships based on cluster sampling. Face-to-face interviews were conducted to collect data. Descriptive analysis was performed to describe demographic characteristics, history of pregnancy and ANC uptake, knowledge of and attitudes towards ANC. Multivariable analysis was used to identify factors associated with uptake of ANC. Results Among 538 women who completed the questionnaires, 77.9% knew that ANC was necessary during and after pregnancy. However, only 24.2% actually accessed ANC. Almost all women (94.6%) expressed their willingness to receive ANC for pregnancy but barriers towards actual uptake of ANC existed including shyness, lack of independence and unavoidable cost. Multivariate analysis showed that no experience of living outside of Zhaojue for more than 6 months, higher number of births, not knowing the necessity of ANC during pregnancy and not knowing the government's promotion policies for ANC were associated with lack of ANC uptake. Conclusion Although ethnic minority women in rural Liangshan expressed strong intention to use ANC, actual uptake of ANC was low. Knowledge of ANC and HIV prevention for MTCT should be improved among this population, and efforts should be made to help them overcome barriers to accessing ANC.
KW - China
KW - antenatal care (anc)
KW - ethnic minority
UR - http://www.scopus.com/inward/record.url?scp=85070748928&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85070748928&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-023699
DO - 10.1136/bmjopen-2018-023699
M3 - Article
C2 - 31420377
SN - 2044-6055
VL - 9
JO - BMJ open
JF - BMJ open
IS - 8
M1 - e023699
ER -