Challenges to maternal health care utilisation among ethnic minority women in a resource-poor region of Sichuan Province, China

A goal of the Chinese government is to improve the quality and use of maternity services. This paper presents a simple descriptive study of maternal health care utilisation (MHCU) among ethnic minority women in a remote region of China.

The paper shows that:

• levels of maternal health service utilisation are very low in the region, and access to antenatal care (ANC) is only received by a minority and postnatal care is even less common.
  
• utilisation of maternal health care services is associated with a range of social, economic, cultural and geographic factors as well as the policies of the state and the delivery of services.
  
• utilisation is not necessarily increased through easy access to a health facility.
  
• women may stay at home for reasons of cost, the poor quality of township hospitals, the cultural inappropriateness of birthing practices, and the lack of incentives such as pain relief during labour.
• practically, current family planning policies counter attempts aimed to increase hospital births.
  

The authors argue that policies’ reconsideration is required. Conclusions include:

• MHCU can be improved through developing the role of village-based health care workers, expanding mobile antenatal care clinics, and changing the way township hospital services are provided and funded.
• moreover, extension of the recent initiative of travelling clinics to village women is likely to be beneficial.
• rather than viewing traditional practitioners as obstacles, working with traditional birth attendants and traditional healers could encourage hospital birth.
• policies that impose punitive measures on struggling township-level staff for not reaching impossible targets for hospital births could be replaced by greater professional and financial support.
• there is a need to improve women’s understanding of appropriate ANC and the importance of emergency obstetric care.