Disadvantaged populations in maternal health in China who and why?
Disadvantaged populations in maternal health in China who and why?
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DOI：
10.3402/gha.v6i0.19542
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发表时间：
2013-04-03
影响因子：
2.6
通讯作者：
Thomsen S
中科院分区：
文献类型：
--
作者：
Yuan B;Qian X;Thomsen S
中国在实现关于孕产妇和生殖健康的千年发展目标方面取得了令人印象深刻的进展，但确保进展惠及所有阶层的人口仍然是决策者面临的一项挑战。本综述的目的是绘制中国孕产妇保健方面的弱势群体，并解释这些不平等的原因，以促进政策行动。我们检索了PUBMED、Popline、Proquest和万方，并纳入了在中国大陆进行的初步研究。还联系了专家，以确定其他研究。根据世卫组织健康问题社会决定因素委员会制定的概念框架，确定和编码了千年发展目标5方面的弱势人口以及作者探讨的这种弱势的原因。在中国，不同收入群体和不同社会经济发展地区之间孕产妇保健服务利用和孕产妇死亡率的差异仍然存在，但这些差异正在缩小。受教育程度低的群体和少数民族群体利用孕产妇保健的频率较低，孕产妇死亡率较高，尽管我们无法确定这些差异在过去十年中是否发生了变化。农村到城市的流动人口使用孕产妇保健和避孕的程度低于城市常住居民，这些群体之间的孕产妇死亡率差异有扩大的趋势。性别不平等也使妇女处于不利地位。解释这些不平等现象的中间因素包括物质环境，如生活在偏远地区的妇女距离卫生设施很远；行为因素，如导致少数民族求医人数减少的传统信仰；以及卫生系统决定因素，如自费支付给穷人造成经济障碍。在中国，孕产妇保健方面的不平等仍然是一个值得加大规划和监测力度的问题。
China has made impressive progress towards the Millennium Development Goal (MDG) for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Inequity in maternal health continues to be an issue worthy of greater programmatic and monitoring efforts in China.
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作者：
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通讯作者：
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作者：
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DOI：
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发表时间：
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影响因子：
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作者：
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