[An evaluation of effects of intervention on maternal and child health in the rural areas of China].
OBJECTIVE
To evaluate the impact of training maternal and child health care providers in the rural areas of China on improvement of health care to pregnant and puerperal women.


METHODS
The data originated from the Reproductive Health/Family Planning Project implemented by the State Family Planning Commission and the Ministry of Health from 1998 to 2002, which covered 32 counties in 22 provinces of China. A quasi-experimental design was used. 6 counties were selected from 32 project counties as the intervention group, while 6 non-project counties were taken as the control group with the condition similar to that of the selected project counties in respect to their number of population and economic level. The subjects of the study were mothers with child under 3 years. A total of 348 mothers were interviewed using a structured questionnaire by strictly trained surveyors. It was focused on prenatal care and postpartum follow-up in the survey.


METHODS
According to the plan of the project, all maternal and child health care providers at the grass-root level were given a 2-week theoretical training, and some of them were assigned to hospitals where they were gievn a 1-month clinical skills training.


RESULTS
With regard to prenatal care, the mothers in intervention group received more prenatal care than those in control group (mean number of obstetric visits: 6.64 vs 5.64, P<0.05). The number of items of examination taken in intervention group was more than that in control group (6.71 versus 5.67, P<0.05). The proportion of the mothers in intervention group who were told that they must visit doctors if they felt uncomfortable in pregnant period, was higher than that in control group (P<0.05). 8 symptoms or signs that possibly occur in pregnant period were listed; in this connection, the mothers in intervention group knew more than those in control group (3.43 vs 2.09, P<0.05). In the postpartum follow-up, more mothers in the intervention group were examined by the doctors. The proportion of mothers who were informed of contraceptive methods was higher in intervention group than in control group (94% vs 78.5%, P<0.05). The descending rate of maternal mortality rate in the intervention areas was much higher than that in the control areas.


CONCLUSIONS
The training of maternal and child health care providers had a significant impact on improving their service skills and quality; consequently, the women covered by their service could receive better maternal and child health care. This indicates that the Reproductive Health/Family Planning Project implemented in the rural areas of China is successful.
Department of Medical Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, China.
Tong
T
Zhang
Yon-qiao
YQ
Wu
Xun
X
Zhang
Qing
Q
Xiong
Yan-ping
YP
Wang
Gong-li
GL
Zhao
Ming-hui
MH
Chen
Zong-zhan
ZZ
Ni
D000328:Adult; D002675:Child, Preschool; D002681:China; D005193:Family Planning Services; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000458:organization & administration*; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care; D011785:Quality Assurance, Health Care; D012423:Rural Health