Dimensions Of Women Research Articles

A qualitative study exploring the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies in Iran

BackgroundIn order to provide appropriate and adequate care to women who have experienced termination of pregnancy due to fetal anomalies, the health needs of this group should be assessed. Considering the lack of information about the care and services required by these women in Iran, this study was conducted with the aim of exploring the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies.MethodsThis study was conducted with a qualitative approach. 40 participants were selected through purposive sampling, and the data were collected through in-depth semi structured interviews and field notes, and analyzed using conventional qualitative content analysis.ResultsAfter analyzing the texts, the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies were categorized in the three main categories: “efficient treatment team”, “optimal organizational structure in providing services” and “financial support for families”.ConclusionsThe findings of the present study by exploring and highlighting the needs related to the health system in different dimensions in women with experience of pregnancy termination due to fetal anomalies can be helpful for designing and providing basic and comprehensive care programs.

The Women's Agency Scale 61 (Was-61): A Comprehensive Measure of Women's Intrinsic, Instrumental, and Collective Agency

Background. Sustainable Development Goal (SDG) 5 prioritizes women’s empowerment, alone and to advance other SDGs. Measures of women’s empowerment have been resource focused; yet, agency (an aspect of empowerment) captures conscientization — the emergence of critical awareness and action for change. A comprehensive measure of women’s agency would capture intrinsic power within to overcome dominated consciousness, instrumental power to pursue aspirations, and collective power with others to pursue shared goals. A valid measure of women’s multidimensional agency is needed to monitor real progress toward SDG5 and women’s well-being. Methods. In this sequential, mixed-methods study, we developed and validated the Women’s Agency Scale 61 (WAS-61) in 930 married women 15–49 years and living with their husband in Matlab, Bangladesh. Using theory, qualitative research, and questionnaire reviews, we developed an item pool to capture women’s intrinsic (43 items), instrumental (23 items), and collective (17 items) agency. We performed exploratory then confirmatory factor analyses (EFA/CFA) in random split-half samples, and estimated pairwise and factor score correlations to confirm that the dimensions of agency were distinct but related in expected ways. In future work, we will perform multiple-group CFA to assess to what extent the WAS-61 is measurement invariant across salient sub-groups of women. Results. A 29-item, three-factor CFA model measured women’s intrinsic agency as endorsement of gender equity and rights (non-justification of wife beating, gender-equitable attitudes) and confidence in capabilities (comfort expressing opinion and going places outside home) (loading: 0.35-0.93, RMSEA=0.04, CFI=0.94, TLI=0.93). Significant pairwise factor correlations (0.10–0.55) confirmed that the intrinsic-agency dimensions were distinct but related. A 27-item, three-factor CFA model measured women’s instrumental agency as use of financial services, voice with husband, and mobility/voice outside home (loading: 0.43-0.99, RMSEA=0.05, CFI=0.94, TLI=0.93). Significant pairwise factor correlations (0.36–0.58) confirmed that the instrumental-agency dimensions were distinct but related. To capture women’s collective agency, an 8-item, one-factor CFA model measured leadership of others (loading: 0.52-0.84, RMSEA=0.10, CFI=0.97, TLI=0.96), and a 7-item, one-factor CFA model measured influence in their community (loading: 0.54-0.83, RMSEA=0.10, CFI=0.96, TLI=0.95). Significant, and generally higher, within-construct than cross-construct pairwise correlations suggested that the dimensions of women’s agency were distinct but related (intrinsic: 0.13–0.60; instrumental: 0.40–0.72; collective: 0.58; cross-construct: 13 of 21 correlations < 0.30). Intrinsic agency in mobility/voice outside home was strongly correlated with measures of instrumental and collective agency (0.28–0.51). Instrumental agency in use of financial services and mobility/voice outside the home were strongly correlated with measures of collective agency (0.38–0.47). Conclusions. The WAS-61 is a comprehensive measure of women’s multidimensional agency validated in married women in rural Bangladesh. These novel scales capture well-defined dimensions of intrinsic, instrumental, and collective agency that are distinct but related. Women’s intrinsic agency in voice/mobility outside the home is strongly related to their instrumental and collective agency, and women’s instrumental agency in use of financial services and voice/mobility outside the home is strongly related to their collective agency. These findings suggest that all dimensions of women’s conscientization are inter-related and necessary for women’s empowerment and well-being. We will test measurement in-variance of the WAS-61 across salient sub-groups of women, and the WAS-61 should be validated in urban women and other samples to confirm its widespread utility for impact assessment of health and development programs and national monitoring. Evidence of time in-variance of the WAS-61 would confirm its utility to monitor national and program-level changes in women’s agency and its influences on other SDGs.

The Body Acceptance by Others Scale: An assessment of its factorial validity in adults from the United Kingdom

The construct of body acceptance by others (i.e., the degree to which an individual perceives acceptance for their appearance by others) is central to conceptual models of positive body image and adaptive eating styles. It is typically measured using the 10-item Body Acceptance by Others Scale (BAOS; Avalos & Tylka, 2006), but emerging research has suggested that a unidimensional model of BAOS scores may be unstable. Here, we examined the factor structure of BAOS scores in a sample of adults from the United Kingdom (N = 1148). Exploratory factor analyses indicated that BAOS scores reduced to two dimensions in women, of which only a primary 6-item factor was stable. In men, all 10 items loaded onto a primary factor. However, the results of confirmatory factor analyses indicated that both models of BAOS scores had poor fit. Although both the unidimensional 10-item and 6-item models had adequate internal consistency, our results are suggestive of factor structure instability. We conclude by suggesting ways in which future research could revise the BAOS to improve its factorial stability and validity.

Intimate partner violence against women and its association with pregnancy loss in Ethiopia: evidence from a national survey

BackgroundIntimate partner violence (IPV) is major public health problem that affects many dimensions of women’s health. However, the role of IPV on women’s reproductive health in general and pregnancy loss in particular, is largely unknown in Ethiopia. Therefore, this study investigated the association between IPV and pregnancy loss in Ethiopia.MethodsA retrospective analysis of nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS) was conducted. Married women of reproductive age (15–49 years) who participated in the domestic violence sub-study of the survey were included in the analysis. Adjusted odds ratios were estimated using multilevel logistic regression models to represent the association of IPV with outcome variable.ResultsAmong 4167 women included in the analysis, pregnancy loss had been experienced by 467 (11.2%). In total, 1504 (36.1%) participants reported having ever experienced any form of IPV, with 25.1, 11.9, and 24.1% reporting physical, sexual and emotional IPV respectively. A total of 2371 (56.9%) women had also experienced at least one act of partner controlling behaviour. After adjusting for potential confounders, a significant association was observed between IPV (a composite measure of physical, sexual and emotional abuse) and pregnancy loss (Adjusted Odds Ratio (AOR) 1.54, 95% Confidence Interval (CI): 1.12, 2.14). The odds of pregnancy loss were also higher (AOR 1.72, 95% CI: 1.06, 2.79) among women who had experienced multiple acts of partner controlling behaviours, compared with women who had not experienced partner controlling behaviours. The intra-class correlation coefficient (ICC) indicated that pregnancy loss exhibits significant between-cluster variation (p < 0.001); about 25% of the variation in pregnancy loss was attributable to differences between clusters.ConclusionIPV against women, including partner controlling behaviour, is significantly associated with pregnancy loss in Ethiopia. Therefore, there is a clear need to develop IPV prevention strategies and to incorporate IPV interventions into maternal health programs.

Associations between women's empowerment and children's health status in Ethiopia.

Although women's empowerment has gained attention over the last two decades, our understanding of the associations between different dimensions of women's empowerment and different children's health outcomes is limited. This study aims to measure the extent of women's empowerment and to examine its associations with the children's health status in Ethiopia. Data were obtained from the 2016 Ethiopian Demographic and Health Survey (EDHS). The sample is restricted to a sub-sample of 10,641 women from 15 to 49 years old and their children under the age of five years. We used children's height-for-age and weight-for-height Z-scores and pneumonia and anemia experience as indicators of children's health outcome. Women's empowerment is measured by five indices reflecting their participation in decision-making, attitudes towards wife-beating by husband, barriers to health care access, asset ownership, and socio-economic variables. These indicators of empowerment were constructed using exploratory and confirmatory factor analysis. A Multiple Indicators Multiple Causes (MIMIC) model was employed to examine the relationship between women's empowerment and latent child health outcomes, after controlling for relevant covariates. Results suggests that enhancing women's empowerment in the household in terms of their socio-economic status (i.e., increasing women's access to education, information, media, and promoting saving) was associated with less likelihood of the children's being stunted or wasted (p<0.05). Higher women's empowerment in terms of household decision-making power were also associated with better children's health status measured by the children's experience of pneumonia and anemia (p<0.05). All aspects of women's empowerment are not related with children's health indicators. Women's empowerment dimensions related with child health have a varying degree of association with the different children's health indicators. Gender-specific policies focusing on increasing women's access to education, media, information, and promoting saving and their participation in the household decision making are some of the strategies for improving their children's health and wellbeing.

Assessing the impacts of land tenure regularization: Evidence from Rwanda and Ethiopia

This article connects theoretical effects of the Land Tenure Regularization (LTR) and available evidence from Rwanda and Ethiopia. Based on a review of 26 quantitative and qualitative relevant and robust studies, the paper contributes to the understanding on what evidence exist to validate the LTR effects and how to gain long-term economic, environmental and social impacts. Results suggest a propensity of well supported evidence for positive LTR effects on investment in soil conservation and the role of LTR in enforcing certain dimensions of women’s empowerment. Agricultural productivity and rental and sale effects are more supported in Ethiopia but with mixed findings for the case of Rwanda. There is lack of any robust evidence for credit mechanism except some very limited support from qualitative studies on Rwanda as well as for youth inclusion in the LTR. Key institutional and economic factors identified for long-term impacts relate to reliable agricultural market incentives and contract arrangement, adapted financial products and services to guaranty credit access and collateralized effects of LTR, and active land markets to support modernised and collective investment in agriculture.

Are urban women empowered in Pakistan? A study from a metropolitan city

This study investigated the empowerment status of urban women in Pakistan using a multidimensional approach in Lahore – a metropolitan city. Analysis of survey data of 260 women revealed that around two-thirds of women were not empowered. Three dimensions of women's empowerment (WE) – control over resources, mobility and participation in household decision making are relatively weak. A significant proportion of women (49%) did not have control over spending of family savings. A majority of them (70-85%) neither had ownership rights of fixed property (i.e. land and house) nor control over its sale. Around 80% and 55% of women had constrained mobility respectively to financial institutions, and friends (out of city). Moreover, a majority of them did not have participation in household decisions on investment of family savings and purchase of fixed property (i.e. land and house), and availing of financial services. Study also revealed that single women are less empowered compared to married women. Likewise, women with salaried employment were also less empowered than non-working women. Based on findings, the study suggested some key recommendations on women's property rights, improving their role in household decision making, ensuring women friendly workplace environment, and public awareness campaigns through media and academic curricula. It is also highlights that WE is not only key to achieve Sustainable Development Goal (SDG) – 5, but can also contribute to achieve several other SDGs.

Indonesia Infant and Young Child Feeding Practice: The Role of Women’s Empowerment in Household Domain

Previous studies showed the significant association between women&amp;rsquo;s empowerment and infant and young child feeding (IYCF) practice. Only around 40% of Indonesian children met adequate IYCF practice. Hence, each dimension of women&amp;rsquo;s empowerment in the household domain must be explored.&#x0D; &#x0D; We carried out a dataset of the 2017 Indonesia Demographic and Health Survey, with samples of 4,880 mothers of reproductive age in a marriage relationship with their last-born child aged 6-23 months. Logistic regression was applied.&#x0D; &#x0D; Mother with legal asset ownerships had lower odds of her child meeting (aOR: 0.83; 95% CI: 0.72, 0.95) minimum dietary diversity (MDD), (aOR: 0.75; 95% CI: 0.65, 0.87) minimum meal frequency (MMF) and (aOR: 0.74; 95% CI: 0.61, 0.90) minimum acceptable diet (MAD). Mother who could control her own earnings had higher odds of her child meeting MDD (aOR: 1.52; 95% CI: 1.32, 1.74) and MAD (aOR: 1.62; 95% CI: 1.34, 1.94). Employed mother had higher odds of meeting MMF (aOR: 1.58; 95% CI: 1.38, 1.82). Mother who did not approve of intimate partner violence was more likely to feed her child with MDD (1.39 times), MMF (1.41 times) and MAD (2.04 times). Mother with three or more parity had lower odds of her child meeting MDD (aOR: 0.81; 95% CI: 0.79, 0.93), MMF (aOR: 0.84; 95% CI: 0.72, 0.99) and MDD (aOR: 0.80; 95% CI: 0.65, 1.00).&#x0D; &#x0D; Mother who did not approve towards domestic violence, was working, controlled her assets and had a maximum of two parity was associated with official IYCF recommendation.

A systematic review of the impact of contemporary treatment modalities for cervical cancer on women's self-reported health-related quality of life.

Given the high survival rate of cervical cancer patients, understanding women's health-related quality of life (HRQL) during and after treatment is of major clinical importance. We conducted a systematic review to synthesize all available evidence about the effects of each contemporary treatment modality for cervical cancer on all dimensions of women's HRQL, including symptoms, functioning, and global HRQL. We searched four electronic databases from January 2000 to September 2019, cross-referenced and searched by author name for studies of patients treated for cervical cancer that reported patient-reported outcomes (PROs) before treatment and with at least one post-treatment measurement. Two independent reviewers applied inclusion and quality criteria and extracted findings. Studies were categorized by treatment to determine specific treatment effects on PROs. Results were narratively summarized. We found twenty-nine papers reporting 23 studies. After treatments with curative intent for early or locally advanced disease, lymphedema, diarrhea, menopausal symptoms, tight and shorter vagina, pain during intercourse, and sexual worries remained long-term problems; however, sexual activity improved over time. HRQL and psychological distress were impacted during treatment with also worsening of global HRQL but improved 3-6months after treatment. In patients with metastatic or recurrent disease, pain improved during palliative treatment or remained stable, with no differences in global HRQL found over time. Whereas most symptoms worsen during treatment and improve in the first 3months after completing treatment, symptoms like lymphedema, menopausal symptoms, and sexual worries develop gradually and persist after curative treatment. These findings can be used to inform clinical practice and facilitate communication and shared decision-making. More research is needed in very early cervical cancer and the impact of fertility sparing therapy on PROs.

Women and participatory constitutionalism

Abstract This article underscores the foundational exclusion of women from constitution-making as an expression of the ideology of separate and gendered spheres dominant at the birth of written constitutionalism. It traces the incorporation of women into constitution-making within a broader gender equality participatory turn taking place, since the late 1980s and especially 1990s, coinciding in time with the rise of popular constitutionalism more broadly speaking. By looking at a variety of examples drawn from multiple jurisdictions across the world, it explores the forms of participation of women in constitution-making both through their gradual (though yet insufficient) incorporation into official constitution-making bodies and institutions and, more importantly, through civil society mobilization. It claims that without taking into account the structural dimension of women’s traditional exclusion from the public sphere and constitution-making it is not possible to have an adequate comprehension of the strategies, challenges, meaning, and impact of women joining constitution-making, all of which I briefly describe.

Empirical testing of destination attribute preferences of women snow-sport tourists along a trajectory of participation

ABSTRACT This study explored women snow-sport tourists’ destination attribute preferences in relation to their participation level (e.g. skill; sport career stage) through a complementary sequential mixed-methods approach. Initially, a model illustrating a trajectory of snow-sport participation, travel behavior and preferences was created through qualitative methods. This paper presents the quantitative testing of this proposed trajectory model and the associated destination attribute preferences. Enduring Involvement was used to quantitatively assess proposed stages of the snow-sport participation trajectory. Exploratory Factor Analysis revealed two dimensions in women's enduring involvement in snow-sports: ‘identity/centrality’ and ‘hedonism’. Additionally, three dimensions were found for destination attributes: ‘resort amenities and activities’, ‘snow-sport conditions and quality’, and ‘price’. A Multivariate Analysis of Variance showed that stages of the trajectory could be quantitatively verified. Analysis of Variance indicated that the importance placed on ‘resort amenities and activities’ decreased as women progressed along the trajectory. ‘Snow-sport conditions and quality’ was rated higher by more advanced skiers/snowboarders. ‘Price’ was rated highly along the trajectory stages.

Women’s empowerment among married women aged 15 to 49 in Myanmar

The present study entails an investigation of the empowerment of married women aged 15 to 49 in Myanmar from socioeconomic and demographic perspectives based on data from the Myanmar Demographic and Health Survey 2015-16. The dimensions of women’s empowerment are categorized into two parts: women’s control over their earnings, and women’s participation in household decision-making (decisions on major household purchases, visits to family or relatives, their health care; and the well-being of their children). These two dimensions are combined to create an index of women’s empowerment. A binary logistic regression is used, by means of odds ratios to assess the relationship between women’s level of empowerment and their socioeconomic and demographic characteristics. Overall, the findings of the study show that a higher empowerment level is associated with women’s employment, increased age, urban residence, a higher educational attainment, a higher wealth quintile, and a lower level of husband’s education. In addition, women that have one child or up to four children are more likely to have a higher level of empowerment than women with no children. About three fourths of the women in the sample live in rural areas. Among those women, the ones with a higher level of empowerment are more educated, employed and have higher household income. Generating employment opportunities for women and educating women are important factors that can lead to an increase in women’s income, and accordingly, help raise the levels of women’s empowerment.

Women's decision-making autonomy and its relationship with child feeding practices and postnatal growth.

Childhood stunting remains a global public health concern. Little has been documented on the effect of women's decision-making autonomy on child growth in settings where decision-making at the household and community levels is largely dominated by men. To assess the relationship between maternal autonomy and child growth, we analysed data from a cross-sectional study of 422 mothers and their youngest child aged 6-24 months in the Bawku West District of Ghana. The dimensions of women's autonomy measured were decision-making power, freedom of mobility and financial autonomy. We then compared how each dimension was associated with the likelihood of stunting and wasting. The important predictors of child growth and dietary intake as measured by the mean length-for-age Z-score (LAZ) and minimum acceptable (MAD) diet, respectively, were determined using multivariable regression models. The overall composite index of women autonomy (CIWA) showed that 52⋅8 % of women were of high autonomy and half of them had higher autonomy regarding their own and their children's health. After adjusting (multiple regression analysis) for potential confounders, the mean LAZ of children born to women of high autonomy was significantly higher than LAZ of children born to women of low autonomy (β = 0⋅132; 95 % CI 0⋅19, 0⋅95; P = 0⋅004). Similarly, high women's autonomy was a significant independent predictor of meeting MAD (AOR = 1⋅59; CI 1⋅09, 2⋅34). Of all, the dimensions of women's autonomy measured in this study, health care autonomy better predicted child growth and dietary intake. Based on the findings, nutrition policies and interventions that enhance women's decision-making autonomy could have a positive impact on child growth outcomes.

Dimensions in women's experience of the perinatal period

A positive experience of the perinatal period is significant for women in midwifery care. The literature on women's experiences of the care in this period is extensive. However, a clear overview of the dimensions important for women's experiences is lacking. Consequently, care providers and researchers may ignore aspects significant to women's experience. In this short communication, we present a framework identifying the dimensions relevant for women's experiences of the perinatal period.

Jane M. Gaines, Pink-Slipped: What Happened to Women in the Silent Film Industries? Kristen Anderson Wagner, Comic Venus: Women and Comedy in American Silent Film. Maggie Hennefeld, Specters of Slapstick and Silent Film Comediennes

It will soon be five decades since Sharon Smith and Anthony Slide each published research revealing the surprising extent of women’s filmmaking during the pre-classical period of American cinema that ended a century ago.1 It has been over twenty-five years since the Women Film Pioneers Project2 was founded by Jane M. Gaines, whose latest book, Pink-Slipped: What Happened to Women in the Silent Film Industries?, sets out to push the ‘reset’ button on feminist film historiography. Meanwhile Kristen Anderson Wagner’s Comic Venus: Women and Comedy in American Silent Film and Maggie Hennefeld’s Specters of Slapstick and Silent Film Comediennes reclaim silent-era comedy, a genre slow to be taken up by feminist scholars, as a means of feminist assault on power structures. This review considers how the three books reconceptualize not only the nature and dimensions of women’s filmmaking and influence in the silent era but those of feminist film history itself.

Socioeconomic Differentials in Employment Status and Involvement in Household Decision-Making Among Ever-Married Women in Nigeria.

Prior studies have assessed economic/instrumental dimensions of women's empowerment relative to its agency dimensions. This study assessed ever-married women's participation in the labor market as a form of agency for empowerment and household decision-making in Nigeria. The study utilizes secondary data from three national surveys of Nigeria's 2003, 2008, and 2013 Demographic and Health Surveys (DHS) to assess the differences and relationship between indices and the status of women's labor market participation and their empowerment or household decision-making over an 11-year period. Explanatory variables adopted were age group, religion, employment status, educational level, household wealth index, and region. Binomial logistic regression was used to predict the proxy variables of women's empowerment from the explanatory variables. Findings showed that women's access to paid employment, educational status, and the household wealth index improved their participation in household decision-making. However, the single factor that consistently increased the likelihood of an ever-married woman to be involved in all forms of household decision-making from 2008 to 2013 was household wealth. Also, religion affected the ability of ever-married women to participate in household decision-making. The ability of Muslim women to participate in all forms of decision-making decreased from 2008 to 2013. The study concluded that the factors that enhance household wealth will enhance married women's ability to be involved in household decision-making. Education of women is, however, a significant contribution to enhancing the balance of inequity between men and women in household decision-making. The attenuating effect of Islam on this prospect needs further investigation and interventions for married women living in Northern Nigeria.

The anti-racist potential of care - political dimensions of women’s engagement in voluntary refugee support work in Germany

ABSTRACTThis article explores the role of gender in volunteering with refugees in Germany and how female volunteers, who outnumber male volunteers considerably, understand their involvement differently from men. Drawing upon quantitative data from two studies with volunteers in refugee work in Germany from 2015 and 2016, I discuss the motivations of female volunteers to engage in refugee support work, the meaning they give to their experience of working with refugees and the values they wish to demonstrate through their voluntary work. The article centrally maintains that refugee support work can be classed as a form of care work and is informed by an ethics and values of care. However, other results unveil that women interpret their care work as an expression of their political attitudes, specifically about anti-racism and anti-right-wing activism, as well, and thereby have recourse to a supposedly male political justification for engaging in volunteering. Thus, this article argues that these two forms of motivation for volunteering, care and politics, do not need to be mutually exclusive. Crucially, voluntary refugee support work represents a unique opportunity for women’s political activism for anti-racism and cultural openness.

Assessment of fractal dimension and panoramic radiomorphometric indices in women with celiac disease.

To assess the panoramic radiomorphometric indices and fractal dimension in women with celiac disease. The sample consisted of 20 women with celiac disease and 20 healthy women (control group). The mandibular cortical index classification, panoramic mandibular index, mental index, and fractal dimension were evaluated on panoramic radiographs. One-way ANOVA with post hoc Tukey test was used for comparison of the linear measurements and fractal dimension between the celiac and control groups, adopting a significance level of 5% RESULTS: There was no significant difference in panoramic radiomorphometric indices or fractal dimension between the celiac and control groups. Panoramic radiomorphometric indices and fractal dimension revealed no significant bone changes in women with celiac disease.

Impacts of the Gender and Entrepreneurship Together Ahead (GET Ahead) training on empowerment of female microfinance borrowers in Northern Vietnam

Abstract Across the world the Gender and Entrepreneurship Together (GET Ahead) training originally developed by the International Labour Organization has been implemented to improve business outcomes and enhance women’s empowerment. This randomized controlled trial is the first rigorous attempt to examine the impact of the GET Ahead training on women’s empowerment. We focus on the impact of offering this training to female microfinance borrowers of TYM, the largest microfinance organization in North Vietnam. A major contribution of this study is that it focuses on different dimensions of women’s empowerment: (1) personal empowerment, measured by control beliefs, and (2) relational empowerment, measured by relational friction and intra-household decision making power. This study also stands out in that we explicitly study whether involving husbands affects the impact of the training. We find that the GET Ahead training improves women’s empowerment on all three aspects: increased control beliefs and intra-household decision making power (only on larger expenditures), and decreased relational friction. However, the results on relational frictions should be taken with care due to possible underreporting. Moreover, in general, we find no additional impacts of inviting husbands to the training. Finally, our results suggest that it takes some time before the training starts to improve women’s empowerment. We observe no short-term but only mid-term effects from before the training to 12 months after the training.

Outcomes analysis of the 3rd round evaluation for China′s tertiary hospitals in Healthcare Improvement Initiative

Objective To assess the implementation of Healthcare Improvement Initiative(the Initiative)by 136 tertiary hospitals nationwide in 2017, and provide reference for improving relevant policies. Methods Hospital questionnaires 1 and 2 were designed, and data were collected by self-report and expert scoring.Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H(K), and Spearman rank correlation were used for statistical analysis. Results The median score of the first 11 dimensions of these hospitals was 91.89%, and that of the first 12 dimensions of 30 women and children hospitals was 90.54%.The total score rate of the top 11 hospitals in the eastern region was higher than that of both the central region and western region(P<0.001). The total score rate of the first 12 dimensions of women and children′s hospitals in the eastern region was higher than that in the central and western regions(P=0.032). The total score rate of the first 11 dimensions of the national level hospitals was higher than that of the local hospitals(P=0.004). The correlation coefficient between the total number of patients and the total score of the first 11 dimensions and the first 12 dimensions was 0.578 and 0.413, respectively. Conclusions Implementation of the Initiative is satisfactory in general.There are however still rooms of improvement for hospitals in the central and western regions, and local level hospitals as well.General hospitals are better than TCm and specialist hospitals.The larger the scale, the better the performance in service improvement. Key words: Health services administration; China Healthcare Improvement Initiative; Tertiary public hospitals; Third round; Third party evaluation