Research on the equity of maternal health service utilization in Changning District, Shanghai
10.3969/j.issn.1006-2483.2025.06.031
- VernacularTitle:上海市长宁区孕产保健服务利用公平性研究
- Author:
Ying HUANG
1
;
Wenli FANG
1
;
Fang BU
1
;
Ye SHEN
2
;
Ning QIAN
3
;
Xuelin BAI
4
;
Shuo YU
5
;
Ji LIANG
5
Author Information
1. Shanghai Changning Maternity and Infant Health Hospital, Shanghai 200050, China
2. Jiangsu Community Health Service Center of Changning District of Shanghai, Shanghai 200050, China
3. Hongqiao Community Health Service Center of Changning District of Shanghai, Shanghai 200052, China
4. Xianxia Community Health Service Center of Changning District of Shanghai, Shanghai 200058, China
5. School of Public Health, Fudan University, Shanghai 200030, China
- Publication Type:Journal Article
- Keywords:
Maternal health service;
Equity;
Concentration index
- From:
Journal of Public Health and Preventive Medicine
2025;36(6):137-141
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the equity and influencing factors of maternal health service utilization in Changning District, Shanghai. Methods A convenience sampling method was used to conduct a questionnaire survey among mothers of children aged 1 to 1.5 years old who received health services from the child health care clinics and EPI clinics of 10 community health service centers in Changning District, Shanghai from March to April 2022. Count data was expressed by frequency and percentage. Chi-square analysis, binomial logistic regression analysis, and multivariate logistic regression analysis were used to analyze fairness-related factors. Rate difference, rate ratio and concentration index were used to represent fairness. Results A total of 696 subjects were investigated, with an average age of (33.35±4.76) years. There were statistically significant differences in service utilization among women with different household registrations only in early pregnancy registration (χ2=11.026, P=0.001) and postpartum visits (χ2=4.989, P=0.026). Women with a career showed differently in folic acid supplement (χ2=6.247, P=0.012), early pregnancy registration (χ2=12.989, P=0.002), physical examination in 42 days postpartum (χ2=4.446, P=0.035) and postpartum contraception (χ2=4.061, P=0.044), and the differences were statistically significant. Women with different monthly family income had a statistically significant difference in pre-pregnancy examination (χ2=8.977, P=0.030) and postpartum visit (χ2=16.114, P=0.001). There was a statistically significant difference between women with maternity insurance or not in the early pregnancy registration (χ2=10.576, P=0.001) and physical examination in 42 days postpartum (χ2=8.166, P=0.004). The results of the multivariate analysis showed that occupation (OR=2.616, 95% CI: 1.142-5.990) and maternity insurance (OR=4.490, 95% CI: 1.992~10.120) affected the utilization of service in early pregnancy registration. The monthly household income (OR=0.278, 95% CI: 0.124-0.625) affected the utilization of services in postpartum visit. At the same time, the monthly household income (10,000-19,999: OR=0.286, 95% CI: 0.090-0.907; ≥30,000: OR=0.180, 95% CI: 0.041-0.801) also affected the utilization of service in physical examination in 42 days postpartum. Conclusion The equity of maternal health care service utilization overall is good in central area in Shanghai, but there is still room for improvement. It is necessary to strengthen community mobilization, propagandize maternal health services, and expand the coverage of maternity insurance to improve the equity of maternal health service utilization and provide equal access to maternity health services.
