Use of Health Services by Women with Gynecological Symptoms in Rural China

Abstract

To examine the relation between demographic factors and symptom type in the use of gynecological health services in rural China. Married women aged 19 to 45 years from three rural communities in Anhui province, central China, were invited to participate in a structured interview in the summer of 2006. They provided information on gynecological symptoms, healthcare-seeking behaviour and socio-demographic characteristics. Risk factors were analyzed using logistic regression. 860/1221(70.4%) reported at least one gynecological symptom during the previous year, with 485 (39.7%) reporting three or more. Of the women with symptoms, 36.7% sought treatment during the previous year. Younger women and those with multiple symptoms were more likely than others to seek treatment. Women with abnormal vaginal bleeding or discharge were more likely to delay seeking treatment. Years of education were strongly related to seeking treatment. More highly educated women and women with a higher household income were more likely than others to seek treatment at the highest level (county or city hospital) of the tertiary healthcare system rather than at a village clinic or township hospital. Women who did not seek treatment were more likely to report that they saw no need than to say that they could not afford care. There may be a misperception of the need for, and utility of, treatment for gynecological symptoms, particularly in more disadvantaged women. Interventions should both address women's negative perceptions and reinforce the capacity of the local health facilities to ensure effective care.