Determining Optimal Strategies to Reduce Maternal and Child Mortality in Rural Areas in Western China: an Assessment Using the Lives Saved Tool / 生物医学与环境科学（英文）

China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists. This study estimated the potential effectiveness of expanding coverage with high impact interventions using the Lives Saved Tool (LiST). It was found that gestational hypertension, antepartum and postpartum hemorrhage, preterm birth, neonatal asphyxia, and neonatal childhood pneumonia and diarrhea are still the major killers of mothers and children in rural area in China. It was estimated that 30% of deaths among 0-59 month old children and 25% of maternal deaths in 2008 could be prevented in 2015 if primary health care intervention coverage expanded to a feasible level. The LiST death cause framework, compared to data from the Maternal and Child Mortality Surveillance System, represents 60%-80% of neonatal deaths, 40%-50% of deaths in 1-59 month old children and 40%-60% of maternal deaths in rural areas of western China.

Investigation on the patterns and knowledge regarding domestic violence among married women in rural areas of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the knowledge and prevalence of domestic violence (DV) among married women in rural China.</p><p><b>METHODS</b>Proportional to Population Size(PPS) sampling method was conducted to select 3998 women aged 18 years old and above from Jilin, Anhui and Chongqing. All the women were interviewed using a standardized questionnaire during Nov. 2004-Jan. 2005.</p><p><b>RESULTS</b>The prevalence of spousal violence against women was 64.8 % in a lifetime and 42.6% in the past 12 months before the survey. Psychological violence was the most common type, followed by physical violence and sexual abuse. The prevalence rates for psychological, physical and sexual violence in a life time were 58.1%, 29.7%, 16.7%, while 37.2%, 14.0%, 7.7% in the past 12 months before the survey. All the total DV, psychological violence and sexual violence were more commonly seen in Jilin province, while physical violence was more prevalent in Chongqing city. The prevalence rate of violence was different among people with different social-demographic characteristics. Sexual abuse became more common with the improvement of education. In total, about 1/3 women suffered two or three categories of violence at the same time. Most sexually abused women suffered one kind of violence, while half of the physically and psychologically abused women suffering two and more kinds of violent behaviors at the same time. Married women had relatively little knowledge on domestic violence and 75.2 % of the women did not even know what domestic violence was referring to and some women suffered from DV themselves but knowing nothing about its implication. In general, physical violence was better understood among interviewed women while the knowledge about psychological violence was relatively poor. Conclusion Domestic violence, psychological violence in particular, was very common in rural China, while the knowledge of DV among married women was poor, effective actions should be taken to stop DV at no time.</p>

Survey on the situation of antenatal care in different regions of China, in 1971 - 2003 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To comprehensively understand the situation of antenatal care in the last thirty years and to identify the existing problems and challenges.</p><p><b>METHODS</b>PPS method was used to select those women under study and face to face interview was carried out at the house.</p><p><b>RESULTS</b>The quality and coverage rate of antenatal care as well as the rate of hospital delivery had been continuously increasing over time and the coverage rate of antenatal checkup had increased from 38.7% in 1970s to 95.9%, while the institutional delivery rose from 20.1% to 87.4% in the last three years. However, problems and challenges were found refering to the of delay first antenatal care, inadequate timing and with incomplete contents. Only 71.7% of the pregnant women had received first checkup during the first three months. 64.1% of the women received 5 times or more of the checkups while only 29.1% of the women had received all the 7 basic checkup items. Rate of hospital delivery was unsatisfactory that most (79.5%) of the women had the delivery not in the hospitals when under the assistance of midwife/village doctors. Indicators showed that the worst was in the western regions.</p><p><b>CONCLUSION</b>Great progress had been made in the field of antenatal care in last thirty yeats in China. The coverage rate of antenatal checkup and institutional delivery had been improved. But the quality of antenatal care should be further improved, especially in the western regions.</p>

Domestic violence against women before, during and after pregnancy / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine patterns of abuse before, during, and after pregnancy and the possible factors related to abuse.</p><p><b>METHODS</b>A community-based face-to-face survey of a representative group of women having a child aged 6 to 18 months in 32 communities of Tianjin, Liaoning, Henan and Shaanxi provinces was carried out between November 1, 2001 and February 28, 2002.</p><p><b>RESULTS</b>The prevalence rate of domestic violence (emotional, sexual and physical) occurred in any period (before, during and after pregnancy) against women was 12.6%. The prevalence of domestic violence against women during the approximate 9 months of pregnancy (4.3%) was relatively lower than that during the 12 months before pregnancy (9.1%) and during the mean 11 months postpartum period (8.3%). Domestic violence against women before pregnancy was a strong risk factor for abuse during and post pregnancy. Abused women and perpetrators were more likely to be in lower social class were smoking cigarettes and drinking alcohol. Abused women were more likely to be witnessing violence in the past and having poor relationship with partner.</p><p><b>CONCLUSION</b>The prevalence of domestic violence against women was high which called for in-depth training and improving awareness for all health professionals.</p>

Domestic abuse on women in China before, during, and after pregnancy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Some researchers found that partner-perpetrated physical violence increased in frequency and severity during the postpartum period compared with the antenatal period, however, limited data exists describing abuse of women in China. The purpose of this study was to examine patterns of abuse in China before, during, and after pregnancy, and explore possible factors related to abuse.</p><p><b>METHODS</b>A community-based face-to-face survey of a representative group of women who had a child aged 6 to 18 months in 32 communities of Tianjin, Liaoning, Henan, and Shaanxi provinces was carried out between November 1, 2001 and February 28, 2002.</p><p><b>RESULTS</b>The prevalence of domestic abuse (emotional, sexual, or physical) occurring in any period (before, during, or after pregnancy) was 12.6%. The prevalence of abuse during the approximate 9 months of pregnancy (4.3%) was relatively lower compared with the prevalence of abuse during the 12 months before pregnancy (9.1%) and after delivery (8.3%) during the mean 11-month postpartum period studied. Abuse before pregnancy was a strong risk factor for abuse during pregnancy and abuse after pregnancy, and abuse during any previous period was a strong risk factor for subsequent abuse. Many women who suffered abuse of any kind generally experienced multiple acts over time and most acts were not severe. The results of logistic regression analysis showed that the factors associated with abuse during pregnancy included women previously witnessing domestic violence, a poor relationship with the partner, socioeconomic level, alcohol consumption, and smoking.</p><p><b>CONCLUSIONS</b>It is necessary to do in-depth training and to raise awareness of partner abuse among all health professionals. Routine screening of abuse in maternity clinics is advocated to decrease the adverse impact of abuse on women and fetuses.</p>

An analysis of related factors for maternal mortality rate at county level / 中华预防医学杂志

<p><b>OBJECTIVE</b>Data collected during a period of six years in implementation of the Health VI Project sponsored by the World Bank were used to analyze maternal mortality rates (MMR) at county level and its related factors, so as to decrease MMR further.</p><p><b>METHODS</b>Routine data on maternal deaths, as well as its related economic, social and cultural factors, during 1995 to 2000 were collected at county level, and univariate analysis was conducted for them.</p><p><b>RESULTS</b>Average MMR reduced remakably by 51.33% from 159.74/100 000 in 1995 to 77.75/100 000 in 2000 in the areas with implementation of the Health VI Project. However, there was still a gap in MMR between the Project areas and the nation as a whole. MMR correlated with local topography, economic and cultural levels, traffic and communication, health resource, and quality of obstetric care service.</p><p><b>CONCLUSIONS</b>In order to lower MMR further, it is necessary to increase financial investment for health, to improve health care service establishments, to strengthen health education for pregnant women and to increase their health awareness so as to improve their use of maternal care and health care services, to improve quality of obstetric care service, to strengthen training for health professionals and to improve their knowledge and skills, and to accelerate construction of traffic and communication.</p>