A Study on the Influencing Factors on Prenatal Care Exam Visits of the Aboriginal and Non-aboriginal Women with Child-bearing Ages in Nantou County

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Title:	A Study on the Influencing Factors on Prenatal Care Exam Visits of the Aboriginal and Non-aboriginal Women with Child-bearing Ages in Nantou County
Authors:	Tsai, Shang-Fu
Contributors:	Department of Healthcare Administration/Healthcare Division Hung-En Liao
Keywords:	Aboriginal Women;Access to Prenatal Care Exam;Out-of-pocket Prenatal Care Exam;Routine Prenatal Care Exam;Prenatal Care Exam Visits
Date:	2012
Issue Date:	2012-11-18 08:47:50 (UTC+0)
Publisher:	Asia University
Abstract:	First Thesis:A Study on the Influencing Factors on Access to Prenatal Care Exams of the Aboriginal and Non-aboriginal Women with Child-bearing Ages in Nantou County AbstractBackground & Objectives:National Department of Health has not only provided maternal health Handbook, including suggesting prenatal exam items and schedule, for pregnant women, but also 10 times of free prenatal care exams visits, to promote access to maternal health. However, for those pregnant women living in the remote areas, can they really get those needed prenatal exams? Or are there other barriers impede their uses of prenatal care exam services? Therefore, the purpose of this study is to investigate the influencing factors on the access to prenatal care exam visits among those aboriginal and non-aboriginal women in child-bearing ages, and to discuss why those pregnant women failed to use needed prenatal care exam services.Methodology:This thesis analyzed a total of 850 women in a secondary data. The source of data was from “The Association between Health Behavior and Adverse Reproductive Outcome among Aboriginal Women in Child-Bearing Ages” project sponsored by The Bureau of Health Promotion in Year 2011. Parts of Andersen's applied model of health services use , including predisposing, enabling, and need factors, were employed as a theoretical structure to discuss the influencing factors on the access to prenatal care exam visits through descriptive and inferential statistical analyses. Results:Results showed that low household income (P<0.05, OR=2.427), residency of Ren-Ai Township (P<0.001, OR=3.818) where is lack of medical resources, and low educational level (P<0.01, OR=3.720) were the determinants on why pregnant women failed to have needed prenatal care exam visits. In addition, those pregnant women, who live in Ren-Ai Township (P<0.01, OR=2.056), relatively young (P<0.05, OR=0.968), with lower educational level (P<0.01, OR=5.733), and without employed (P<0.01, OR=3.256), tended to fail in having out-of-pocket needed genetic screening.Conclusion & Suggestion:The influencing factors on the access to prenatal care exam visits among aboriginal and non-aboriginal women in child-bearing ages encompass predisposing factors (i.e., educational level, occupation), enabling factors (i.e., household income, residential area), but no need factors, indicating that the consumption of prenatal care exam resources is not distributed by need. Thus, we suggest a subsidy of transportation fee to those pregnant women who live in remote areas when they need to have prenatal care exam visits. Also, we suggest a full-coverage subsidy on genetic screening to those pregnant women who are in health risk and living in remote areas. Meanwhile, proceeding a continuous health education to those aboriginal women in pregnancy is recommended.Second Thesis:A Study on the Influencing Factors on the Adequacy of Prenatal Care Exam Visits of the Aboriginal and Non-aboriginal Women with Child-bearing Ages in Nantou County AbstractBackground & Objectives:National Department of Health has offered pregnant women 10 times of free prenatal care exams to early diagnose maternal health problem as well as to prevent unnecessary complications and adverse birth outcomes. However, for those pregnant women living in the remote areas, is there difference between pregnant women in different ethnic group in getting those adequate prenatal exams? Or are there barriers impede their routinely 10 times uses of prenatal care exam services? Therefore, the purpose of this study is to compare frequency of the prenatal care exam visits of pregnant women in different ethnic group, and to analyze the influencing factors on whether pregnant women have adequate prenatal care exam visits.Methodology:This thesis analyzed a total of 1,725 maternal secondary data. The source of data was from “The Association between Health Behavior and Adverse Reproductive Outcome among Aboriginal Women in Child-Bearing Ages” project sponsored by The Bureau of Health Promotion in Year 2011. That project adopted a case-control comparison method, with random sampling design, collecting 850 valid questionnaires from women in child-bearing ages lodged in Ren-Ai (i.e. case) and Pu-Li (i.e., control) townships. Parts of Andersen's applied model of health services use , including predisposing, enabling, and need factors, were employed as a theoretical structure to discuss the influencing factors on the access to adequate prenatal care exam visits through descriptive and inferential statistical analyses. Results:Although the average times of prenatal care exam visits of aboriginal pregnancy women (10.58) was significantly higher (t=2.581, P<0.05) than that of the non-aboriginal women (10.21), the proportion of insufficient (i.e., less than 10 times) prenatal care exam visits in aboriginal pregnant women were higher than that in non-aboriginal pregnant women (26.6% VS16.5%). Through the logistic regression analysis, the result showed that pregnant women living in Ren-Ai Township where is in remote area (OR=2.589) or gave birth in younger age (OR=0.965) were intended to have insufficient prenatal care exam visits.Conclusion & Suggestion:There is indeed a significant difference between aboriginal and non-aboriginal pregnant women in the average uses of prenatal care exam services. In addition, the influencing factors on the adequacy of prenatal care exam visits encompass predisposing (i.e., the age of pregnant women), and enabling factors (i.e., residential area), but not the ethnic or need factors. Thus, we suggest the necessity to promote the access to prenatal care exam visits for those pregnant women living in remote areas, and to initiate a health education program to those young aboriginal women.
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