What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis

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 retai...

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Main Authors: Chongyi Wei, Bo Liu, Duorui Shi, Lei Nan, Bibo Yin, Aga Emu, Haiqun Zhou, Wuha Wazha, Jianming Zhu, Shumei Wang, Wei Ma
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e023699.full
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author Chongyi Wei
Bo Liu
Duorui Shi
Lei Nan
Bibo Yin
Aga Emu
Haiqun Zhou
Wuha Wazha
Jianming Zhu
Shumei Wang
Wei Ma
author_facet Chongyi Wei
Bo Liu
Duorui Shi
Lei Nan
Bibo Yin
Aga Emu
Haiqun Zhou
Wuha Wazha
Jianming Zhu
Shumei Wang
Wei Ma
author_sort Chongyi Wei
collection DOAJ
description 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.
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spelling doaj-art-1d8ed219c1cd439a80f6adc437da0a2b2024-11-25T21:25:13ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-023699What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysisChongyi Wei0Bo Liu1Duorui Shi2Lei Nan3Bibo Yin4Aga Emu5Haiqun Zhou6Wuha Wazha7Jianming Zhu8Shumei Wang9Wei Ma106 Department of Epidemiology and Biostatistics & Global Health Sciences, University of California, San Francisco, California, USAInner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China3 School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China5 Department of AIDS Control and Prevention, Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China5 Department of AIDS Control and Prevention, Liangshan Prefecture Center for Disease Control and Prevention, Xichang, China7 Zhaojue Maternal and Child Care Service Centre, Zhaojue, China7 Zhaojue Maternal and Child Care Service Centre, Zhaojue, China8 Zhaojue Zhuhe Central Hospital, Zhaojue, China9 Zhaojue Abingluogu Central Hospital, Zhaojue, China1 Department of Epidemiology, Shandong University School of Public Health, Jinan, China1 Institute for Emergency and Disaster Medicine, Sichuan Academy of Medical Science, Sichuan Provincial People`s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaBackground 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.https://bmjopen.bmj.com/content/9/8/e023699.full
spellingShingle Chongyi Wei
Bo Liu
Duorui Shi
Lei Nan
Bibo Yin
Aga Emu
Haiqun Zhou
Wuha Wazha
Jianming Zhu
Shumei Wang
Wei Ma
What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis
BMJ Open
title What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis
title_full What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis
title_fullStr What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis
title_full_unstemmed What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis
title_short What factors hinder ethnic minority women in rural China from getting antenatal care? A retrospective data analysis
title_sort what factors hinder ethnic minority women in rural china from getting antenatal care a retrospective data analysis
url https://bmjopen.bmj.com/content/9/8/e023699.full
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