Abstract
ABSTRACT
Background: China is making efforts to reduce maternal mortality. But there are still over ten thousand women who die of maternal causes every year. Research on underlying factors of maternal mortality is insufficient. No study has reported on ethnicity and health service resources factors.
Objective: To describe maternal mortality and investigate factors associated with maternal mortality ratio (MMR) in the study areas of Xinjiang region and Jilin province, and to compare the difference between two provinces.
Methods: A retrospective study was carried out among 24 counties in Xinjiang and 19 counties in Jilin in 1997, it identified 339 maternal deaths in Xinjiang and 73 maternal deaths in Jilin. Questionnaires were used to collect data at individual and county level.
Results: MMR in study areas of Xinjiang was much higher than in Jilin. The majority of maternal deaths belonged to ethnic minorities in Xinjiang and ethnic Han in Jilin. The major medical cause in both provinces was obstetric hemorrhage. Study subjects in Xinjiang with high gravidity and parity were more common than in Jilin, and the majority were among ethnic minorities. Study subjects in Xinjiang without clean delivery were much more common than in Jilin and almost all delivered at home. One-fifths of study subjects in both provinces had not received treatment. Antenatal care rate in Xinjiang was much lower than in Jilin.
The factors associated with maternal mortality in study areas of Xinjiang were the percentage of minority groups, average number of village doctors and the proportion of villages without doctors. In Jilin these were skilled MCH personnel per 1000 population and hospital delivery rate.
Conclusions: High MMR is an important health problem in the study areas of Xinjiang. Health education activities to promote the advantages of hospital delivery thereby increasing hospital delivery rate are required. It is important to create the conditions for hygienic home delivery, especially in remote rural areas where hospitals are inaccessible. Pregnant women should be encouraged to improve their self health care consciousness and protect themselves from social and cultural factors. More effective strategies are needed to reduce the maternal mortality, particularly among ethnic minorities in western regions.