Women's status, institutional barriers and reproductive health care: a case study in Yunnan, China.

OBJECTIVES: Yunnan is one of the poorest and most remote provinces in China. The reproductive health status of the population is poor. The aim of the study was to identify factors contributing to poor reproductive health and major barriers in accessing reproductive health information and care and to inform interventions to increase access to and the quality of care in service delivery. METHODS: The study was based on qualitative data collected from structured and unstructured interviews with health program managers, service providers, clients, and community members in three counties. Focus group discussions, field observations, reviews of the records of medical facilities and thematic analysis were used in the study. RESULTS: Gender inequality and the fragmented health system were some of the barriers in accessing the services. Incorrect diagnosis, over treatment and IUD insertion with un-sterilised tools may have contributed to the persistent high rate of reproductive tract infections (RTI) in the study settings. CONCLUSIONS: The improvement of reproductive health thus hinges critically upon the elevation of women's status. All health sectors within China's health system need to be better integrated and institutionally induced gender inequality ought to be reduced so that all in the population, particularly the vulnerable, will have equal and adequate access to reproductive health care.