title: Effectiveness of an intervention on uptake of maternal care in four counties in Ningxia, China.
abstract: OBJECTIVE
  To understand the utilisation of prenatal care and hospitalised delivery among pregnant Muslim women in Ningxia, China, and to explore the effectiveness of the integrated interventions to reduce maternal mortality.
  
  
  METHODS
  Cross-sectional surveys before and after the intervention were carried out. Using multistage sampling, 1215 mothers of children <5 years old were recruited: 583 in the pre-intervention survey and 632 in the post-intervention study. Data on prenatal care and delivery were collected from face-to-face interviews. Maternal mortality ratio (MMR) data were obtained from the local Maternal and Child Mortality Report System.
  
  
  RESULTS
  After the intervention, the MMR significantly decreased (45.5 deaths per 100,000 live births to 32.7 deaths). Fewer children were born at home after the intervention than before the intervention (OR, 0.11; 95% CI, 0.08-0.15). The proportion of women who attended prenatal care at least once increased from 78.2% to 98.9% (OR, 24.55; 95% CI, 11.37-53.12). The proportion of women who had prenatal visit(s) in the first trimester of pregnancy increased from 35.1% to 82.6% (OR, 8.77; 95% CI, 6.58-11.69). The quality of prenatal care was greatly improved. Effects of the intervention on the utilisation of maternal care remained significant after adjusting for education level and household possessions.
  
  
  CONCLUSIONS
  The findings suggest that integrated strategies can effectively reduce maternal mortality.
authors.affiliation: Department of Child, Adolescent and Women's Health, Peking University, Beijing, China  United Nations Children's Fund China Office, Beijing, China  Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhou
authors.forename: Chun-Xia
authors.initials: CX
authors.lastname: Zhao
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Wang
authors.forename: Yi-Chong
authors.initials: YC
authors.lastname: Xv
authors.forename: Ling
authors.initials: L
authors.lastname: Shi
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000328:Adult; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007514:Islam; D008297:Male; D008427:Maternal Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D008428:Maternal Mortality / Q000208:ethnology*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D012423:Rural Health