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

Gao, Yu, Barclay, Lesley, Kildea, Sue, Hao, Min and Belton, Suzanne (2010) Barriers to increasing hospital birth rates in rural Shanxi Province, China. Reproductive Health Matters, 18 36: 35-45. doi:10.1016/S0968-8080(10)36523-2

Author Gao, Yu
Barclay, Lesley
Kildea, Sue
Hao, Min
Belton, Suzanne
Title Barriers to increasing hospital birth rates in rural Shanxi Province, China
Journal name Reproductive Health Matters   Check publisher's open access policy
ISSN 0968-8080
Publication date 2010-11
Year available 2010
Sub-type Article (original research)
DOI 10.1016/S0968-8080(10)36523-2
Open Access Status
Volume 18
Issue 36
Start page 35
End page 45
Total pages 11
Place of publication Amsterdam, The Netherlands
Publisher Elsevier BV
Collection year 2010
Language eng
Formatted 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. 
Keyword Antenatal care
Health worker attitudes
Quality of care
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
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Citation counts: TR Web of Science Citation Count  Cited 16 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 27 Aug 2014, 13:29:07 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work