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Determinants of the Use of Prenatal Care in Rural China: the Role of Care Content

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Abstract

Several maternal demographic factors have been identified to influence the timing of starting prenatal care and its adequate use. However, how the content of prenatal care modifies these factors has not been studied previously. Using a representative sample collected for other purposes in rural China, we examined the factors predicting the uptake of prenatal care by taking into account the content of care (advice: on nutrition during pregnancy, diseases and pregnancy-related problems, and on child care after birth; and routine tests: blood pressure, blood tests, and ultrasound). We studied 1,479 women who answered a house-hold KAP (knowledge, attitude, and practice) survey (97% response rate) collected after a prenatal care intervention from 2001 to 2003 in 20 townships located in a county in Anhui Province. A multinomial logistic regression was used for the analysis. The most prominent factors that predicted late start of prenatal care and inadequate care were younger age, low maternal income, and having more than one child. When we adjusted for the content of care, the influence of these factors on the use of prenatal care attenuated to varying degrees: in some cases there was up to 20% reduction in the values of the risk estimates, while in other cases the statistical significance of the estimates were lost. It is important to take into account the content of prenatal care when assessing the factors predicting women’s use of prenatal care.

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Acknowledgments

We thank Haifeng Xu, Rengui Zhang, Ying Wang, and Zhang Yu for their contributions to the data collection. This study was funded by Academy of Finland and Commission of the European Communities.

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Authors and Affiliations

  1. Tampere School of Public Health, University of Tampere, 33014, Tampere, Finland

    Bright I. Nwaru

  2. Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, China

    Zhuochun Wu

  3. Department of Public Health, University of Helsinki, Helsinki, Finland

    Zhuochun Wu

  4. National Institute for Health and Welfare, Helsinki, Finland

    Elina Hemminki

Authors
  1. Bright I. Nwaru
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  2. Zhuochun Wu
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  3. Elina Hemminki
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Corresponding author

Correspondence to Bright I. Nwaru.

Appendix

Appendix

See Table 5.

Table 5 Definition of the content of prenatal care
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Nwaru, B.I., Wu, Z. & Hemminki, E. Determinants of the Use of Prenatal Care in Rural China: the Role of Care Content. Matern Child Health J 16, 235–241 (2012). https://doi.org/10.1007/s10995-010-0734-0

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  • DOI: https://doi.org/10.1007/s10995-010-0734-0

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