Analysis of the implementation and influencing factors of urban maternal health management project from the perspective of equal access of basic public health services

Objective To investigate and analyze the cognition, utilization, and influencing factors of the health management project of basic public health services in urban pregnant woman, in order to promote the smooth implementation of equal access of basic public health services. Methods A multi-stage random sampling method was used to recruit participants. First, eight streets under the jurisdiction of the survey area were divided into three levels, high, medium, and low according to the level of economic development using the stratified random sampling method. One street was selected from each of the three levels as a sample street, and then using the cluster sampling method, a questionnaire survey was administered to 290 urban pregnant women in the three streets. Pregnant women's awareness of service items and utilization status were described and analyzed by statistical rate indicators. The possible factors affecting the utilization of service items were analyzed by χ2 analysis and logistic regression. Significant differences were observed between the two methods (P<0.05). Results The 282 urban pregnant women were between 22-44 years, and had an average age of 29.19±4.05 years. Among them, 72.7% were primipara, 12.4% had an abnormal birth history and 65.6% were at 28 weeks of pregnancy. The highest awareness rate of basic public health services was found in medical examinations during pregnancy (81.6%), and the lowest awareness rate was found in two follow-up visits (30.1%) during 28-40 weeks of pregnancy. There were significant differences in the establishment of maternal health handbook (χ2=12.075, P=0.034), accepting assessment of maternal health and fetal growth (χ2=11.154, P=0.048), and accepting prenatal guidance (χ2=19.878, P=0.001) among pregnant women who held different jobs. Additionally, there were significant differences in the establishment of maternal health handbook (χ2=6.211, P=0.045) and prenatal guidance (χ2=13.175, P=0.001) among pregnant women at different gestation periods. The awareness of basic public health services for pregnancy, the enthusiasm of service utilization, and the degree of attention were also important factors affecting the utilization of health services among pregnant women. Conclusion There are apparent deficiencies in cognition and utilization of the health management project among pregnant women in Jining city, which indicates the need to improve the implementation of the project. The government should strengthen promotion and education, increase funding, expand the scope of services, and promote the effective implementation of maternal health management projects. Fundamentally, the equal access of basic public health services should be realized, which would benefit the public and particularly relevant groups. Key words: Pregnant women; Health services; Influence factors