Utilisation of antenatal care in four counties in Ningxia, China

To analyse and evaluate the antenatal care services and its quality so as to improve the antenatal care, and make it more available and cost-effective.

Retrospective survey. A multistage sampling technique was used to select townships and villages.

The four rural counties of a project in Ningxia Hui Autonomous Region in northwest China, where more than one half of the population was Hui ethnicity, the average hospital delivery rate was 47% in 2005, and the maternal mortality ratio was estimated to be higher than 65 deaths per 100,000 live births in 2005.

Five hundred and fifty-four mothers of children under the age of five were interviewed at home using a structured questionnaire between August and September in 2006. No mothers refused to take part in the survey.

The percentage using antenatal care, the number of antenatal visits and the timing of the first antenatal visit during the pregnancy of the youngest child were analysed. 78.2% of the mothers had received antenatal care services, but only 12.9% had at least five antenatal visits and 35.2% had their initial visit in the first trimester. Only 9.0% whose first antenatal visit took place during the first trimester had at least five antenatal visits. Ethnicity was an important factor determining antenatal care use. Hui mothers had significantly lower odds ratios of obtaining antenatal care in the first trimester (OR = 0.32, P < 0.001) or having at least five antenatal visits (OR = 0.11, P < 0.001) than Han mothers.

The quality of the antenatal care which the women received was low. It is necessary to rethink the current model of antenatal care, and to develop and standardise a new model of antenatal care.