Internal migration and maternal health service utilisation in Jiangsu, China

Abstract

Abstractobjectives To investigate the use of maternal health care services by internal migrants in view of their migration status.methods Cross-sectional household survey in two cities of Jiangsu Province. Questions elicited data on socioeconomic information and MHC service use (pre-natal examination, post-natal visit, prenatal health education). Chi-square tests and multivariate logistic regression analyses were used to identify factors associated with MHC service use.results A total of 946 married women were recruited, of whom 22.3% were internal migrants. Compared to local residents, migrants were five times less likely to attend pre-natal examinations (84.4% vs. 91.7%; OR = 0.49, P = 0.002), three times less likely to have post-natal visits (15.6% vs. 50.2%; OR = 0.18, P < 0.001) and less likely to attend health education during pregnancy (87.0% vs. 95.7%; OR = 0.30, P < 0.001). Multivariate logistic regression also revealed a lower proportion of MHC use among migrants (ORm 0.52, 0.16, and 0.3, respectively).conclusions Internal migrants in Jiangsu Province underuse MHC services to a significant degree. More attention needs to be paid to pregnant migrant women, as they are vulnerable group in society.keywords maternal health care, internal migrant, health service utilisation, logistic regression

Prenatal care among rural to urban migrant women in China

“…Whether these percentages are “high” or “low” depends on the comparison group. Other studies indicate that these percentages are lower than for rural women in sending communities, but higher than for natives of the cities where these women now live [20, 26, 32]. Our results indicate that women who were migrants when they became pregnant were more likely to receive timely and adequate prenatal care than similar women who migrated after their pregnancy.…”

“…84.2% in Guangzhou [19]; 84.4% vs . 91.7% in Jiangsu province [20]). Another study in Shanghai showed that while 90.1% of migrant women had at least one prenatal care visit, only 49.7% had the five or more antenatal care visits recommended and only 19.7% visited an antenatal care center during the first trimester [16].…”

“…Migrant women with younger age, lower educational level, and lower household income were less likely to have 5 or more prenatal examinations [16, 24]. Factors associated with higher likelihood of receiving adequate prenatal care include longer residency in the receiving community, first pregnancy, having medical insurance, husbands with higher educational level, and staying in the receiving community during pregnancy (as opposed to returning to their home town) [4, 20, 25, 26]. …”

The association between the supply and utilization of community-based primary care and child health in a context of hospital-oriented healthcare system in urban districts of Guangdong, China: a panel dataset, 2014–2016

“…This may be explained by the financial and geographical accessibility, and the comprehensiveness of primary care [11,27,38,48]. However, there are studies indicating that interprovincial migrants' utilization of healthcare service is lower compared to that of local district residents in the district [17,18,21,49,50]. Since the two primary care indicators did not fully capture the interprovincial migrants' true utilization rate of services, combined with their reported underuse of healthcare service, our results may underestimate the association between greater utilization of primary care and improved health of the interprovincial migrants.…”

“…According to the national census in 2010, the resident population of Guangdong province was 104.3 million with over 20% interprovincial migrants [15]. Since the Chinese national policy has long been set up on a household registration system (hukou), a locality-based scheme, migrants are often excluded from comprehensive health insurance, local benefits of education, public health services, and housing [16][17][18][19][20], which makes them vulnerable and susceptible to a special set of health risks [21]. Children and women are particularly affected by these social determinants of health.…”