Abstract
ObjectiveTo investigate the levels of primary health care services for children and their changes in Zhejiang Province, China from 1998 to 2011.MethodsThe data were drawn from Zhejiang maternal and child health statistics collected under the supervision of the Health Bureau of Zhejiang Province. Primary health care coverage, hospital deliveries, low birth weight, postnatal visits, breastfeeding, underweight, early neonatal (<7 days) mortality, neonatal mortality, infant mortality and under-5 mortality were investigated.ResultsThe coverage rates for children under 3 years old and children under 7 years old increased in the last 14 years. The hospital delivery rate was high during the study period, and the overall difference narrowed. There was a significant difference (P<0.001) between the prevalence of low birth weight in 1998 (2.03%) and the prevalence in 2011 (2.71%). The increase in low birth weight was more significant in urban areas than in rural areas. The postnatal visit rate increased from 95.00% to 98.45% with a significant difference (P<0.001). The breastfeeding rate was the highest in 2004 at 74.79% and lowest in 2008 at 53.86%. The prevalence of underweight in children under 5 years old decreased from 1.63% to 0.65%, and the prevalence was higher in rural areas. The early neonatal, neonatal, infant and under-5 mortality rates decreased from 6.66‰, 8.67‰, 11.99‰ and 15.28‰ to 1.69‰, 2.36‰, 3.89‰ and 5.42‰, respectively (P<0.001). The mortality rates in rural areas were slightly higher than those in urban areas each year, and the mortality rates were lower in Ningbo, Wenzhou, and Jiaxing regions and higher in Quzhou and Lishui regions.ConclusionPrimary health care services for children in Zhejiang Province improved from 1998 to 2011. Continued high rates of low birth weight in urban areas and mortality in rural areas may be addressed with improvements in health awareness and medical technology.
Highlights
In 2000, 189 heads of governments and at least 23 international organizations signed the Millennium Declaration, committing to achieve eight goals for health and development
We investigated the levels of primary health care services for children under 7 years old and trends from 1998 to 2011, which is helpful to promote the primary health care services in our province, even the whole China
Data Collection The data about child health care services in Zhejiang Province were extracted from the Zhejiang Maternal and Child Health Statistics collected under the supervision of the Health Bureau of Zhejiang Province
Summary
In 2000, 189 heads of governments and at least 23 international organizations signed the Millennium Declaration, committing to achieve eight goals for health and development. Millennium Development Goal (MDG) 4 was to reduce under-5 mortality by two-thirds between 1990 and 2015. Progress in reducing child mortality was substantially slower than the targeted annual rate of decline (4.4%) in some countries, especially developing countries. A series of laws and regulations aiming to improve child health, education, law enforcement and the environment were implemented, including the 1994 Maternal and Infant Health Care Law of the People’s Republic of China [4] and the 1995, 2001, and 2011 Guidelines for Chinese Children’s Development [5,6]. [4] The main child health goals of the Guidelines for Chinese Children’s Development (2011–2020) are reducing infant mortality and under-5 mortality to 10 and 13 per 1000, respectively. The goals include reducing disability, promoting the national immunization program (vaccination), and encouraging exclusive breastfeeding, reducing the incidence of low birth weight and reducing the prevalence of anemia. [5,6] Zhejiang
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