Accessibility to delivery care in Hubei Province, China

Zhuolin Tao; Yang Cheng; Shishuai Du; Ling Feng; Shaoshuai Wang

doi:10.1016/j.socscimed.2020.113186

Accessibility to delivery care in Hubei Province, China

Soc Sci Med. 2020 Sep:260:113186. doi: 10.1016/j.socscimed.2020.113186. Epub 2020 Jul 12.

Authors

Zhuolin Tao¹, Yang Cheng², Shishuai Du³, Ling Feng⁴, Shaoshuai Wang⁵

Affiliations

¹ Faculty of Geographical Science, Beijing Normal University; No.19, XinJieKouWai St., Haidian District, Beijing, 100875, China. Electronic address: taozhuolin@hotmail.com.
² Faculty of Geographical Science, Beijing Normal University; No.19, XinJieKouWai St., Haidian District, Beijing, 100875, China. Electronic address: chengyang@bnu.edu.cn.
³ Faculty of Geographical Science, Beijing Normal University; No.19, XinJieKouWai St., Haidian District, Beijing, 100875, China; Shandong Experimental High School, Jinan, Shandong, 250001, China. Electronic address: 1187255403@qq.com.
⁴ Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, 430030, China. Electronic address: fltj007@163.com.
⁵ Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, 430030, China. Electronic address: colombo2008@sina.com.

PMID: 32683160
DOI: 10.1016/j.socscimed.2020.113186

Abstract

Accessibility to delivery care is crucial for improving maternal health, which is an important policy goal to ensure healthy lives and promote well-being in China and worldwide, especially with the change of the family planning policy in China in 2016. This study develops a set of methods to project the population of women of child-bearing age and birth population and assess the accessibility to delivery care services in Hubei Province. The Cohort-Component projection method with various scenarios was applied to project the population of women of children-bearing age in 2030. A Gravity-based Variable Two-Step Floating Catchment Area (GV2SFCA) method is developed, which takes into account the heterogeneous catchment areas and distance decay effects for different regions and various levels of delivery care services. The parameters are calibrated by using medical records with patients' addresses. The traditional Supply-Demand Ratio method is also applied. The results demonstrate an overall decreasing trend of birth population in Hubei in all scenarios, but with significant disparities across regions. In 2016, 28% of districts fail to reach the policy goal with 17 beds per thousand births. In 2030, accessibility to delivery care is projected to increase in 98% of districts, while there are still 22% of districts that fail to reach the policy goal. The accessibility scores are further combined with the densities of birth population to identify shortage areas of delivery care. 7% and 6% of districts are classified as Major Shortage Areas in 2016 and 2030, respectively. The findings shed lights on the distributions and future changes of accessibility to and shortage areas of delivery care in Hubei, which can provide evidence-based recommendations for planning and policymaking. It also provides innovative methods for more accurately assessing accessibility to delivery care.

Keywords: Accessibility; Delivery care; Distance decay effects; Medical records; Projection; Variable catchments.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Catchment Area, Health
Child
China
Female
Health Services Accessibility*
Humans