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Chinese maternal health in adjustment: claim for life
Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0003-0368-050X
School of Public Health, Fudan (Shanghai Medical) University, Shanghai, China.
Karolinska Institutet, Stockholm, Sweden.
2002 (English)In: Reproductive health matters, ISSN 0968-8080, E-ISSN 1460-9576, Vol. 10, no 20, 95-107 p.Article in journal (Refereed) Published
Abstract [en]

Health sector reforms in China, instituted starting in 1985, have centred on cost recovery, with fee-for-service revenue replacing public budget funding. The share of public funding for maternal health services was reduced greatly, forcing an increasing proportion of pregnant women to pay for deliveries and treatment of pregnancy-related complications out of pocket, as most had no health insurance to cover these costs. This study aimed to identify socio-economic variables associated with utilisation of essential maternal health services and linked to health sector reforms in China, with a focus on cost recovery. A retrospective household survey (n = 5756) was carried out in six counties in three provinces of Central China in 1995. Antenatal service utilisation continued to improve in 1990-95, but only in relation to the number of visits, which were pre-paid if the woman was participating in a maternal pre-payment scheme or covered by another health insurance scheme. Significant decreases were found in the utilisation of skilled attendance at delivery and hospital delivery, as well as differences in adverse pregnancy outcomes (miscarriages and stillbirths) between women paying out of pocket and those covered by insurance. This study confirms a strong association between utilisation of delivery services and financing variables of amount of savings in the bank, maternal pre-payment schemes and health insurance. It also shows the critical importance of out-of-pocket, fee-for-service payments for maternity care as a barrier to the utilisation of these services.

Place, publisher, year, edition, pages
2002. Vol. 10, no 20, 95-107 p.
Keyword [en]
maternal and child health, health insurance, reproductive health, China
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-11663DOI: 10.1016/S0968-8080(02)00076-9ISI: 000180952700010PubMedID: 12557646Scopus ID: 2-s2.0-0036863566OAI: oai:DiVA.org:mdh-11663DiVA: diva2:394129
Projects
SAREC
Funder
Sida - Swedish International Development Cooperation Agency
Available from: 2011-02-03 Created: 2011-02-01 Last updated: 2015-08-05Bibliographically approved

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CiteExportLink to record
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Citation style
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