Factors associated with antenatal care service utilization among women of childbearing age in rural areas of Shaanxi province:a structural equation model analysis

ObjectiveTo study current status and direct and indirect influencing factors of antenatal care service utilization among women of childbearing age in rural areas of Shaanxi province,and to provide evidences for making policy on health care of the women.MethodsA population-based cross-sectional survey was conducted with a questionnaire survey about health care of the women during perinatal period in rural areas of Shaanxi province.Stratified multistage random sampling was adopted to obtain a sample of 4 779 women giving birth to their children during 2007-2009.Confirmatory factor analysis was used to construct measure models.Parameters and final model were fitted and revised by generalized weighted least square technique.ResultsOf all the women,63.5% had their first antenatal care check within 12 gestation weeks;43.8% received 5 times or more antenatal care checks;30.2% of them completed all required examinations;89.3% attended township hospitals or higher level health facilities for their antenatal care checks;but only 14.2% had qualified antenatal care checks.Structural equation modeling analysis showed that family characteristics,women's social-demographic characteristics,and health knowledge had effect on antenatal care utilization,with the effectiveness percentages of 62.1%,24.4%,and 12.5%,respectively.ConclusionThe quality of antenatal care for pregnant women living in rural areas of Shaanxi province needs to be improved.Health promotion on antenatal care in these areas should target on childbearing women who are from poor families,with lower educational level,and at elder age.