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Clan‐involved approaches to increasing antenatal care use in a rural minority area of China: implementation research
Author(s) -
Ma Wei,
Liu Bo,
Nan Lei,
Portela Anayda,
Yin Bibo,
Wei Chongyi,
Rollins Nigel,
Wang Shumei,
Emu Aga,
Zhou Haiqun
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14357
Subject(s) - medicine , attendance , context (archaeology) , family medicine , clan , prenatal care , health care , postnatal care , pregnancy , nursing , environmental health , population , sociology , anthropology , economics , biology , economic growth , paleontology , genetics
Aim This study aimed to test a model which involved clans and health providers to increase antenatal care attendance in rural minority areas of China with high HIV prevalence. Methods Formative research was conducted to determine barriers and facilitators to antenatal care use. A strategy involving clans in addressing the barriers identified was developed. Implementation of the new strategy was done through three plan‐do‐study‐act (PDSA) cycles, lasting four months each. Results Awareness and uptake of antenatal care increased significantly after the intervention. The proportion of post‐partum women who used any antenatal care increased from 21.3% to 64.5% (p < 0.001), and the proportion who knew that antenatal care is necessary increased from 77.8% to 89.8% (p < 0.001). The proportion of pregnant women who attended antenatal care (p < 0.001) and the proportion of pregnant women who went for a first antenatal care visit in early pregnancy (p < 0.001) all showed increasing trends during the study period. Conclusion Involving clans in antenatal care programmes in rural minority areas of China had an impact on antenatal care use. A quality improvement approach incorporating PDSA cycles can help local health authorities make context‐specific, evidence‐informed decisions to improve uptake of health services.