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Barriers to increasing hospital birth rates in rural Shanxi Province, China

Overview of attention for article published in Sexual and Reproductive Health Matters, November 2010
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Title
Barriers to increasing hospital birth rates in rural Shanxi Province, China
Published in
Sexual and Reproductive Health Matters, November 2010
DOI 10.1016/s0968-8080(10)36523-2
Pubmed ID
Authors

Yu Gao, Lesley Barclay, Sue Kildea, Min Hao, Suzanne Belton

Abstract

This study investigated the reasons for continued high rates of home births in rural Shanxi Province, northern China, despite a national programme designed to encourage hospital deliveries. We conducted semi-structured interviews with 30 home-birthing women in five rural counties and drew on hospital audit data, observations and interviews with local health workers from a larger study. Multiple barriers were identified, including economic and geographic factors and poor quality of maternity care. Women's main reasons for not having institutional births were financial difficulties (n=26); poor quality of antenatal care (n=13); transport problems (n=11); dissatisfaction with hospital care expressed as fear of being in hospital (n=10); convenience of being at home and continuity of care provided by traditional birth attendants (TBAs) (n=10); and belief that the birth would be normal (n=6). These barriers must all be overcome to improve access to and acceptability of hospital birth. To ensure that the national policy of improving the hospital birth rate is implemented effectively, the government needs to improve the quality of antenatal and delivery care, increase financial subsidies to reduce out-of-pocket payments, remove transport barriers, and where hospital birth is not available in remote areas, consider allowing skilled attendance at home on an outreach basis and integrate TBAs into the health system.

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Mendeley readers

The data shown below were compiled from readership statistics for 137 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Sweden 1 <1%
United Kingdom 1 <1%
Iran, Islamic Republic of 1 <1%
Nigeria 1 <1%
Estonia 1 <1%
Unknown 132 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 27 20%
Researcher 25 18%
Student > Bachelor 14 10%
Student > Ph. D. Student 13 9%
Student > Postgraduate 9 7%
Other 32 23%
Unknown 17 12%
Readers by discipline Count As %
Medicine and Dentistry 44 32%
Nursing and Health Professions 25 18%
Social Sciences 22 16%
Psychology 6 4%
Economics, Econometrics and Finance 4 3%
Other 14 10%
Unknown 22 16%