Table 2.
Characteristics of county hospitals, county-level maternal and child health institutions, and township hospitals in 42 rural counties in western China, 2011
| County hospitals (n=41) | County-level maternal and child health institutions (n=35) | Township hospitals (n=464) | |||
|---|---|---|---|---|---|
| Number of births per year | 811 (459–1866) | 402 (5–1041) | 52 (0–101) | ||
| Number of obstetric care providers per facility | 17 (11–24) | 9 (4–16) | 2 (0–3) | ||
| Number of deliveries per obstetric care provider* per year | 54 (36–86) | 42 (3–80) | 16 (0–56) | ||
| Proportion of births by caesarean section (only for facilities providing caesarean sections) | 21% (8–35) | 25% (14–65) | 13% (6–20) | ||
| Basic emergency obstetric care† | |||||
| Parenteral antibiotics | 41 (98%) | 31 (89%) | 385 (88%) | ||
| Parenteral uterotonic drugs | 40 (95%) | 30 (86%) | 257 (59%) | ||
| Parenteral anticonvulsants | 39 (93%) | 21 (60%) | 122 (28%) | ||
| Manual removal of placenta | 39 (93%) | 25 (71%) | 189 (43%) | ||
| Removal of retained products | 39 (93%) | 27 (77%) | 111 (25%) | ||
| Assisted vaginal delivery | 38 (90%) | 21 (60%) | 107 (24%) | ||
| Perform newborn resuscitation | 39 (93%) | 22 (63%) | 134 (31%) | ||
| At least basic care (seven signal functions) | 35 (83%) | 17 (49%) | 39 (9%) | ||
| Comprehensive emergency obstetric care† | |||||
| Perform blood transfusion | 35 (85%) | 13 (38%) | 17 (4%) | ||
| Perform surgery | 36 (88%) | 17 (50%) | 34 (8%) | ||
| Comprehensive care (seven signal functions of basic care and two signal functions of comprehensive care) | 32 (78%) | 13 (38%) | 13 (3%) | ||
| Emergency newborn care | |||||
| Normal newborn careठ| 41 (100%) | 22 (65%) | 265 (61%) | ||
| Kangaroo mother care for premature or small babies§ | 33 (80%) | 12 (35%) | 67 (15%) | ||
| Antibiotic treatment for neonatal infections§ | 40 (98%) | 20 (59%) | 221 (50%) | ||
| Neonatal ventilation§¶ | 28 (68%) | 8 (24%) | 90 (21%) | ||
| Water and sanitation|| | |||||
| Piped water | 36 (90%) | 34 (100%) | 240 (52%) | ||
| Water from wells, containers, or trucks | 4 (10%) | 0 | 212 (46%) | ||
| No water | 0 | 0 | 11 (2%) | ||
| Hygienic latrine | 40 (98%) | 31 (91%) | 283 (61%) | ||
| Unhygienic or no latrine | 1 (2%) | 4 (12%) | 180 (39%) | ||
| Length of stay, days | |||||
| Vaginal delivery** | 4 (3–6) | ·· | 3 (2–5) | ||
| Caesarean delivery** | 7 (7–9) | ·· | 7 (7–8) | ||
| Maternity waiting rooms | |||||
| Facility providing maternity waiting rooms† | 39 (93%) | 25 (74%) | 273 (62%) | ||
| Number of women who arrived before labour started†† | |||||
| Total** | 2392 (67%) | ·· | 608 (62%) | ||
| Vaginal delivery** | 1662 (65%) | ·· | 542 (61%) | ||
| Caesarean delivery** | 727 (72%) | ·· | 64 (72%)‡‡ | ||
| Cost of delivery in facility, ¥ | |||||
| Vaginal delivery | 925 (800–1200) | 860 (800–1000) | 600 (500–700) | ||
| Caesarean delivery | 2900 (2425–3275) | 2200 (2000–2700) | 1600 (1200–2200)‡‡ | ||
| Out-of-pocket expenditure by family for delivery, ¥ | |||||
| Vaginal delivery** | 600 (180–1300) | ·· | 60 (0–300) | ||
| Caesarean delivery** | 2000 (1000–3500) | ·· | 800 (200–2005)‡‡ | ||
Data are median (range) or n (%).
Defined as all personnel providing obstetric care, including doctors and nurses.
Based on 42 county hospitals, 34 county-level maternal and child health institutions offering obstetric care, and 438 township hospitals.
Defined as thermal protection, infection prevention including hygienic cord care, drying the baby immediately after delivery, applying eye ointment after delivery, weighing the baby after delivery, initiating breastfeeding within 1 h after delivery, delaying bathing for at least 6 h after delivery, and teaching the mother to express milk and feed with spoon and cup if the baby is unable to breastfeed.
Data are missing for one county-level maternal and child health institution offering obstetric care and 26 township hospitals.
Defined as intubation and assisted respiration, and safe administration of oxygen.
Data on water were missing for one county hospital, one MCH county institution offering obstetric care, and one township hospital; data on sanitation are missing for one township hospital.
Data were collected from the survey in 42 counties in 2011; in the survey, the option on place of delivery was designated as hospitals at county-level, township-level, or at home, with no question to further distinguish between county-level hospitals and county-level maternal and child health institutions.
Based on 3559 women delivering in county hospitals and 984 women giving birth in township hospitals.
Township hospitals are only authorised to perform vaginal deliveries, although in 2011 some of township hospitals in remote mountain areas were allowed to perform caesarean sections.