Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China
Abstract Background The maternal mortality rate (MMR) markedly decreased in China, but there has been a significant imbalance among different geographic regions (east, central and west regions), and the mortality in the western region remains high. This study aims to examine how much disparity in th...
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BMC
2017-09-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-017-4765-y |
| _version_ | 1819205872403873792 |
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| author | Yan Ren Ping Qian Zhanqi Duan Ziling Zhao Jay Pan Min Yang |
| author_facet | Yan Ren Ping Qian Zhanqi Duan Ziling Zhao Jay Pan Min Yang |
| author_sort | Yan Ren |
| collection | DOAJ |
| description | Abstract Background The maternal mortality rate (MMR) markedly decreased in China, but there has been a significant imbalance among different geographic regions (east, central and west regions), and the mortality in the western region remains high. This study aims to examine how much disparity in the health system and MMR between ethnic minority and non-minority counties exists in Sichuan province of western China and measures conceivable commitments of the health system determinants of the disparity in MMR. Methods The MMR and health system data of 67 minority and 116 non-minority counties were taken from Sichuan provincial official sources. The 2-level Poisson regression model was used to identify health system determinants. A series of nested models with different health system factors were fitted to decide contribution of each factor to the disparity in MMR. Results The MMR decreased over the last decade, with the fastest declining rate from 2006 to 2010. The minority counties experienced higher raw MMR in 2002 than non-minority counties (94.4 VS. 58.2), which still remained higher in 2014 (35.7 VS. 14.3), but the disparity of raw MMR between minority and non-minority counties decreased from 36.2 to 21.4. The better socio-economic condition, more health human resources and higher maternal health care services rate were associated with lower MMR. Hospital delivery rate alone explained 74.5% of the difference in MMR between minority and non-minority counties. All health system indicators together explained 97.6% of the ethnic difference in MMR, 59.8% in the change trend, and 66.3% county level variation respectively. Conclusions Hospital delivery rate mainly determined disparity in MMR between minority and non-minority counties in Sichuan province. Increasing hospital birth rates among ethnic minority counties may narrow the disparity in MMR by more than two-thirds of the current level. |
| first_indexed | 2024-12-23T04:58:36Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-12-23T04:58:36Z |
| publishDate | 2017-09-01 |
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| series | BMC Public Health |
| spelling | doaj.art-8e6b2ad58b254856963618df62aadbf22022-12-21T17:59:16ZengBMCBMC Public Health1471-24582017-09-0117111010.1186/s12889-017-4765-yDisparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western ChinaYan Ren0Ping Qian1Zhanqi Duan2Ziling Zhao3Jay Pan4Min Yang5West China School of Public Health, Sichuan UniversitySichuan Provincial Maternal and Child Health HospitalHealth and Family Planning Information Centre of Sichuan ProvinceSichuan Provincial Maternal and Child Health HospitalWest China School of Public Health, Sichuan UniversityWest China School of Public Health, Sichuan UniversityAbstract Background The maternal mortality rate (MMR) markedly decreased in China, but there has been a significant imbalance among different geographic regions (east, central and west regions), and the mortality in the western region remains high. This study aims to examine how much disparity in the health system and MMR between ethnic minority and non-minority counties exists in Sichuan province of western China and measures conceivable commitments of the health system determinants of the disparity in MMR. Methods The MMR and health system data of 67 minority and 116 non-minority counties were taken from Sichuan provincial official sources. The 2-level Poisson regression model was used to identify health system determinants. A series of nested models with different health system factors were fitted to decide contribution of each factor to the disparity in MMR. Results The MMR decreased over the last decade, with the fastest declining rate from 2006 to 2010. The minority counties experienced higher raw MMR in 2002 than non-minority counties (94.4 VS. 58.2), which still remained higher in 2014 (35.7 VS. 14.3), but the disparity of raw MMR between minority and non-minority counties decreased from 36.2 to 21.4. The better socio-economic condition, more health human resources and higher maternal health care services rate were associated with lower MMR. Hospital delivery rate alone explained 74.5% of the difference in MMR between minority and non-minority counties. All health system indicators together explained 97.6% of the ethnic difference in MMR, 59.8% in the change trend, and 66.3% county level variation respectively. Conclusions Hospital delivery rate mainly determined disparity in MMR between minority and non-minority counties in Sichuan province. Increasing hospital birth rates among ethnic minority counties may narrow the disparity in MMR by more than two-thirds of the current level.http://link.springer.com/article/10.1186/s12889-017-4765-yEthnic disparityMaternal mortality rateHealth systemChina |
| spellingShingle | Yan Ren Ping Qian Zhanqi Duan Ziling Zhao Jay Pan Min Yang Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China BMC Public Health Ethnic disparity Maternal mortality rate Health system China |
| title | Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China |
| title_full | Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China |
| title_fullStr | Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China |
| title_full_unstemmed | Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China |
| title_short | Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China |
| title_sort | disparities in health system input between minority and non minority counties and their effects on maternal mortality in sichuan province of western china |
| topic | Ethnic disparity Maternal mortality rate Health system China |
| url | http://link.springer.com/article/10.1186/s12889-017-4765-y |
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