Reproductive health service utilization and social determinants among married female rural-to-urban migrants in two metropolises, China

Abstract

Reproductive health (RH) education and services of female migrants in China have become an important health issue. This research aimed to investigate the RH knowledge and utilization among married female migrants, and to explore the influencing factors from the perspectives of population and sociology. We conducted a cross-section survey in Shenzhen and Wuhan, China, using the purposive sampling method. A total of 1021 rural-to-urban married migrants were recruited, with 997 valid survey results obtained. A face-to-face structured questionnaire survey was used, with primary focus on knowledge of fertility, contraception, family planning policy and sexual transmitted diseases/acquired immunodeficiency syndrome (STD/AIDs), and RH service utilization. The results showed that the RH service utilization (38.0%) was at a low level in married migrants and the accessibility of RH service was poor. Females who migrated to (OR=0.32) Wuhan obtained fewer RH consultations than those in Shenzhen. The workers with high school education received additional RH consultations and checkup services than those with other background education, apart from the white collar workers who received extra RH consultations and checkup services than the blue collar workers (P<0.05). We can draw a conclusion that the utilization of RH services in married female migrants remains at a low level in China. RH service utilization can be improved via the relevant health departments by enhancing the responsibility of maternal and health care in the community health service center.

Keywords

rural-to-urban migrant / married female / reproductive health service

References

[1] ZhengZZ, ZhouY, ZhengLX, et al. . Sexual behaviour and contraceptive use among unmarried, young women migrant workers in five cities in China. Reprod Health Matters, 2001, 9(17): 118-127 PMID: 11468827

[2] BearingerLH, SievingRE, FergusonJ. Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential. Lancet, 2007, 369(9568): 1220-1231 PMID: 17416266

[3] GlasierA G A, SchmidGP, et al. . Sexual and reproductive health: a matter of life and death. Lancet, 2006, 368(9547): 1595-1607 PMID: 17084760

[4] BlancAK. The effect of power in sexual relationships on sexual and reproductive health: An examination of the evidence. Stud Fam Plann, 2001, 32(3): 189-213 PMID: 11677692

[5] KongsriaS, LimwattananonbS, SirilakcS, et al. . Equity of access to and utilization of reproductive health services in Thailand: national Reproductive Health Survey data, 2006 and 2009. Reprod Health Matters, 2011, 19(37): 86-97

[6] YangXY, LiSZ, FeldmanMW. Development and validation of a gender ideology scale for family planning services in rural China. PLoS One, 2003, 8(4): 59919

[7] ChenJJ, LiuHY, XieZM. Effects of rural-urban return migration on women’s family planning and reproductive health attitudes and behavior in rural China. Stud Fam Plann, 2013, 41(1): 31-44

[8] WangCT. History of the Chinese family planning program: 1970-2010. Contraception, 2012, 85(6): 563-569 PMID: 22176797

[9] BairdDT, EversJL, Gemzell-DanielssonK. Family planning 2011: better use of existing methods, new strategies and more informed choices for female contraception. Hum Reprod Update, 2012, 18(6): 670-681

[10] DingQJ, HeskethT. Family size, fertility preferences, and sex ratio in China in the era of the one child family policy: results from national family planning and reproductive health survey. BMJ, 2006, 333(7564): 371-373 PMID: 16690642 PMCID: 1550484

[11] LiX, StantonB, FangX, et al. . Social stigma and mental health among rural-to-urban migrants in China: A conceptual framework and future research needs. World Health Popul, 2006, 8(3): 14-31 PMID: 18277106 PMCID: 2249560

[12] DegniF, SuominenS E B, et al. . Communication and cultural issues in providing reproductive health care to immigrant women: health care providers’ experiences in meeting Somali women living in Finland. J Immigr Minor Health, 2011, 14(2): 330-343

[13] HuX, CookS, SalazarMA. Internal migration and health in China. Lancet, 2008, 372(9651): 1717-1719 PMID: 18930533

[14] Kramer MA, van Veen MG, de Coul EL, et al. Migrants traveling to their country of origin: A bridge population for HIV transmission? Sex Transm Infect, 2008,84(7):554–555

[15] LiuHY, RuXM, DingF. Reproductive health services for the floating population. Renkou Yanjiu (Chinese), 2004, 28(5): 92-96

[16] SwainSN, SaggurtiN, BattalaM, et al. . Experience of violence and adverse reproductive health outcomes, HIV risks among mobile female sex workers in India. BMC Public Health, 2011, 11: 357 PMID: 21599984 PMCID: 3116498

[17] DeckerMR, McCauleyHL, PhuengsamranD. Sex trafficking, sexual risk, sexually transmitted infection and reproductive health among female sex workers in Thailand. J Epidemiol Community Health, 2011, 65(4): 334-339 PMID: 20515895

[18] LuCY, XuLC, WuJ, et al. . Sexual and reproductive health status and related knowledge among female migrant workers in Guangzhou, China: a cross-sectional survey. Eur J Obstet Gynecol ReprodBiol, 2012, 160(1): 60-65

[19] HeskethT, YeXJ, LiL, et al. . Health status and access to health care of migrant workers in China. Public Health Rep, 2008, 123(2): 189-197 PMID: 18457071 PMCID: 2239328

[20] TsaiSY, SunWJ. Evaluating the satisfaction of immigrant women from a rural community regarding family functioning and health-related quality of life. Women Health, 2013, 53(2): 135-153 PMID: 23517512

[21] LiuZ, ZhuM, DibHH, et al. . RH knowledge and service utilization among unmarried rural-to-urban migrants in three major cities, China. BMC Public Health, 2011, 11: 74 PMID: 21284893 PMCID: 3044659

[22] YangHU, LiZ, ChenHW. Analysis on the healthy reproduction demand and the service reach ability of women floating population in Baoan district of Shenzhen city. Yixue Yu Shehui (Chinese), 2006, 19: 19-21

[23] LianW, LiuGY, ShiSH. Floating population reproductive health services to get married men and evaluation. Zhongguo Shehui Yixue (Chinese), 2008, 25: 49-51

[24] LiZ, ShiSH. Demand for and accessibility to RH service of urban floating population. J Huazhong Univ Sci Technolog Med Sci, 2005, 25(5): 608-611 PMID: 16463689

[25] YangRC, XiaoYH, XieXD, et al. . Analysis on demand and utilization status of reproductive health service and influencing factors in rural married women of childbearing age. Zhongguo Fuyou Baojian (Chinese), 2013, 28(27): 4493-4495

[26] State Council of People’s Republic of China. China’s action plan for reducing and preventing the spread of HIV/AIDS (2006–2010). State Council Document (2006) http://www.beinet.net.cn/zcfg/gh/qggh/200802/P020080423600734513667.

[27] ChenP. Measures needed to strengthen strategic HIV/AIDS prevention programs in China. Asia Pac J Public Health, 2006, 19: 3-7