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Maternal Health Behaviors and Outcomes in a Nomadic Tibetan Population

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Abstract

Introduction Despite significant global improvements in maternal health, large disparities persist. In China, rural women and women who live in western regions experience lower rates of maternal healthcare utilization and higher rates of maternal mortality than women elsewhere in the country. This paper examines maternal health care-seeking among nomadic Tibetan women in rural western China, a particularly understudied group. Methods Secondary data analysis was conducted with survey data collected in 2014 in Qinghai Province, China. Participants (rural, nomadic, adult women) provided birth histories and information on care received during antenatal, intrapartum and/or postpartum period(s). Using bivariate and multivariable logistic regression models, these outcomes were explored in relation to maternal characteristics (e.g., educational attainment and parity), use of health insurance, and time. Results Approximately half of all women had ever used antenatal care, institutional delivery, and/or skilled birth attendance. The utilization of these services has increased over time, from 10% of births prior to the year 2000, to approximately 50% since 2000. Utilization increased by year (odds ratios ranging from 1.1 to 1.3) even after controlling for covariates. Women with health insurance coverage were significantly more likely to use these services than women without insurance, although less than 20% of women reported that insurance paid for any antenatal and/or childbirth care. Discussion Utilization of maternal care is improving among this population but rates remain low in comparison to other women in rural, western China. Further targeted interventions may be needed to reach and adequately address the maternal health needs of this unique population.

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Acknowledgements

Support from Thousand-End Creative Talents Program Scholars of Qinghai Province (青海省“高端创新人才千人计划”项目). We also gratefully acknowledge support from the UCLA Bixby Center on Population and Reproductive Health.

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Authors and Affiliations

  1. University of California Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095, USA

    Corrina Moucheraud, Subasri Narasimhan & Jessica Gipson

  2. Tso-Ngon (Qinghai) University Tibetan Medical College, No. 16 Kunlun Road Rd., Xining, 810001, Qinghai, People’s Republic of China

    Lhusham Gyal, Kunchok Gyaltsen & Lumo Tsering

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  1. Corrina Moucheraud
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  2. Lhusham Gyal
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  3. Kunchok Gyaltsen
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  4. Lumo Tsering
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  5. Subasri Narasimhan
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  6. Jessica Gipson
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Correspondence to Corrina Moucheraud.

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Moucheraud, C., Gyal, L., Gyaltsen, K. et al. Maternal Health Behaviors and Outcomes in a Nomadic Tibetan Population. Matern Child Health J 22, 264–273 (2018). https://doi.org/10.1007/s10995-017-2398-5

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