A Study On The Status And The Changes Of Reproductive Health And Services Of Childbearing Women In China

[BACKGROUND]: China has effectively slowed down its too rapid population growth. The focus of its family planning program is shifting to maintaining a stable and low birth rate, raising the quality of the population in terms of health and education, enhancing happiness of families and bringing population into balance with resources, environment and sustainable social development. the Chinese government pays great attention to reproductive health services,and efforts have been made to initiate a reorientation of guiding-ideology and approaches of its family planning programme. A client-oriented comprehensive quality of care has been emphasized in the provision of reproductive health services. During the Ninth Five-Year Plan period, China has engaged in means of exploring a new way of thinking and approaches for family planning/reproductive health services by implementing a series of projects on quality of care. Therefore, it is of great significance to study the progress and problems in the very field that highlights fertility and contraception of women at childbearing age and family planning / reproductive health services.[OBJECTIVES]:General Objective: To assess the progress made and problems exist in family planning/ reproductive health(FP/RH) services in recent years, and try to provide strategic recommendations for further improving the quality of care in FP/RH services with the purpose of promoting the sustainable development of national reproductive health programme in China.Specific Objectives:--To study the characteristics and development of fertility of childbearing women; --To study the progress and problems in the provision of maternity care services;--To find out the changes of induced abortion rate and services provided; --To analyze the trends of the patterns of contraceptive-mix and the provision of services; --To study the status of and difficulties in reproductive health services in westernChina. [METHODS]:STUDY DESIGN: "the National Demographic and Reproductive Health Survey in 2001" was conducted by using the same design and same sample points for "the National Demographic and Reproductive Health Survey in 1997". The sampling process was based on a three-stage design with a proportional allocation in stratified random sample. Altogether 337 counties from 31 provinces (autonomous regions or municipalities) were selected, in each of which 3 or 4 towns were further selected, and the final sample unit was one village group from each town. The total number of village groups was 1041. Women aged from 15 to 49 years old who met the sample selection criteria were enrolled in the study. A total of 39,586 women at childbearing age were personally interviewed with a structured questionnaire. The response rate was 98.27%. The questionnaire contained eight parts, including the information of women's general demographic characteristics, fertility, contraception, induced abortion and reproductive health services received, etc. The survey was conducted in June 2001. Critical quality control was carried out throughout the designing, implementing and analyzing process ANALYSIS STRATEGY: The status, changes and influencing factors of women's fertility, contraception, induced abortion and relevant services received were analyzed with combined univariate and multivariate analysis. Changes of dependent variables and influencing factors were preliminarily analyzed by using Chi-square test, trend test and correlation analysis method. More detailed analyses were conducted by using stratified analysis and multivariate models. The current study focused on the comparisons of service utilization between the periods of 1994 -- 1996 and 1998 -- 2000. Data were analyzed by using SAS software 8.02, in which multivariate analysis was conducted by using GLM, LOGISTIC and CATMOD procedure.[RESULTS]: After a slight decline, the fertility rate has been stabilized at a low level. General fertility rate (GFR) dropped from 59.08‰ in 1993 to 40.61‰ in 2000. Ther...