ArticleInternational journal for equity in health2021
Hukou-based rural-urban disparities in maternal health service utilization and delivery modes in two Chinese cities in Guangdong Province.
Article in International journal for equity in health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers and facilitators of messaging platforms as a means of maternal support and care in rural communities: A systematic review.PloS one · 2025Pooled it
- Improving Equitable Access to Antenatal Care in China: Challenges and Potential Innovative Approaches.China CDC weekly · 2026Article
- Dynamic analysis of critical maternal complications in tertiary hospitals in Wuxi: A study based on four years of monitoring data.PloS one · 2026Article
- Associated Factors for Cesarean Section in Pregnant Women with Gestational Diabetes Mellitus.International journal of women's health · 2026Article
- Mental health outcomes and rehabilitation challenges in children with orthopedic trauma: a public health survey from a pediatric rehabilitation center.Frontiers in public health · 2025Article
- Challenges in rural maternal health: how received public services and policy awareness affect health knowledge and practices.Frontiers in public health · 2024Article
- Disparity in hospital beds' allocation at the county level in China: an analysis based on a Health Resource Density Index (HRDI) model.BMC health services research · 2023Article
- Reduced-visit antenatal care model combined with telemedicine for low-risk pregnant women: protocol for a randomised controlled trial.BMJ open · 2023Article
- Factors Associated with Willingness toward Organ Donation in China: A Nationwide Cross-Sectional Analysis Using a Social-Ecological Framework.Healthcare (Basel, Switzerland) · 2023Article
- Rural-urban disparities in caesarean deliveries in sub-Saharan Africa: a multivariate non-linear decomposition modelling of Demographic and Health Survey data.BMC pregnancy and childbirth · 2022Article
- Does social participation decrease the risk of frailty? Impacts of diversity in frequency and types of social participation on frailty in middle-aged and older populations.BMC geriatrics · 2022Article
- How do Chinese people perceive their healthcare system? Trends and determinants of public satisfaction and perceived fairness, 2006-2019.BMC health services research · 2022Article
- Community-based interventionFrontiers in public health · 2022Article
- Couple-level determinants of syphilis infection among heterosexual married couples of reproductive age in Guangdong Province, China: A population-based cross-sectional study.Frontiers in public health · 2022Article
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Abstract
backgroundMost existing research on rural-urban health inequalities focuses on disparities in service access and health outcomes based on region. This paper examines rural-urban disparities in maternal healthcare utilization and delivery modes based on household registration (hukou) status to understand the role of state institutions in producing healthcare disparities in China.
methodsUtilizing administrative data from the Public Maternal Health Insurance scheme, we analyzed 54,733 live births in City A (2015-2019) and 25,849 live births in City B (2018-2019) in Guangdong Province in China. We constructed regression models using hukou status (rural versus urban) as the explanatory variable.
resultsWhile there is no statistically significant difference in rural and urban mothers' probability of obtaining the minimum recommended number of prenatal care checkups in City A (OR = 0.990 [0.950, 1.032]), mothers with rural hukou status have a lower probability of obtaining the minimum recommended number of visits in City B than their counterparts with urban hukou (OR = 0.781 [0.740, 0.825]). The probability of delivering in tertiary hospital is lower among mothers with rural hukou than among those with urban hukou in both cities (City A: OR = 0.734 [0.701, 0.769]; City B: OR = 0.336 [0.319, 0.354]). Mothers with rural hukou are more likely to have a Cesarean section than those with urban hukou in both cities (City A: OR = 1.065 [1.027, 1.104]; City B: OR = 1.127 [1.069, 1.189]). Compared with mothers with urban hukou, mothers with rural hukou incurred 4 % (95 % CI [-0.046, -0.033]) and 9.4 % (95 % CI [-0.120, -0.068]) less in total medical costs for those who delivered via Cesarean section and 7.8 % (95 % CI [-0.085, -0.071]) and 19.9 % (95 % CI [-0.221, -0.177]) less for those who delivered via natural delivery in City A and City B, respectively.
conclusionsRural hukou status is associated with younger age, no difference or lower probability of having a minimum number of prenatal checkups, higher likelihood of delivering in nontertiary hospitals, increased Cesarean delivery rates, and lower medical cost for delivery in these two Chinese cities. Evaluating how hukou status influences maternal healthcare in Chinese cities is important for devising targeted public policies to promote more equitable maternal health services.
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