scholarly journals Maternity Insurance Fund Depletion and Universal Two-Child Policy in Qinghai Province in China

2021 ◽  
pp. 465-478
Author(s):  
Henry Asante Antwi ◽  
Tamires Lizandra Andrade Paixao ◽  
Maxwell Opuni Antwi
Keyword(s):  
Maternal Health ◽  
Medical Profession ◽  
Western China ◽  
Insurance Fund ◽  
Contribution Rate ◽  
Health Crisis ◽  
Qinghai Province ◽  
Minority Ethnic Groups ◽  
Child Policy ◽  
Health Initiatives

Since the dawn of humanity, women have acquitted themselves creditably with this responsibility of childbirth even at the peril of their lives. Overtime, the politics, process and social mores that surround pregnancy and birth have evolved along with the growth and maturity of the medical profession, and the art and craft of motherhood. However, the introduction of the universal two-child policy in China without corresponding change in the income and expenditure mix of the maternity insurance schemes in Qinghai province threatens the sustainability of maternal health initiatives for minority ethnic groups in Western China. The analytical model used in this study hybridizes a system dynamics and actuarial model to express the maternity insurance expenditure and income function. The study noted that at the current contribution rate of 0.5%, the maternity insurance fund in Qinghai province will be depleted by the end of 2020 and this can influence catastrophic maternal health crisis in the poorer region. The analysis also shows that if the contribution rate can be raised to 0.75%, the depletion rate of the maternity insurance can be prolonged. We proposed an increase in the current rate of contribution of the maternity insurance fund in Qinghai province; improve investment income for the maternity insurance fund and other reliable sources of sustainable funding.

scholarly journals A Comparative Analysis of Impact of Universal Two-Child Policy on Maternity Insurance Fund in Jiangsu Province and Guangxi Zhuang AR

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 468
Author(s):  
Henry Asante Antwi ◽  
Lulin Zhou ◽  
Xinglong Xu ◽  
Tehzeeb Mustafa
Keyword(s):  
Positive Impact ◽  
Jiangsu Province ◽  
Insurance Fund ◽  
Additional Contribution ◽  
Contribution Rate ◽  
Short Term ◽  
Health Crisis ◽  
Child Policy ◽  
The Impact

The maternity insurance fund in some provinces in China has accumulated unprecedented deficit levels. This imminent depletion can cause a catastrophic health crisis for maternal health. This study analyzed the post-policy impact of key factors on maternity insurance income inflow and outflow in Jiangsu Province and Guangxi Zhuang Autonomous Region (AR). We applied Pasera’s ARLD model and VECM Granger Causality Test to establish long- and short-term impact of selected factors that determines the income and expenditure of the maternity insurance fund in the two regions based on data from 2011 to 2019. Our results show that the addition of new births due to the universal two-child policy has increased the per capita utilization of the maternity insurance fund in both areas. We further observed that the impact of the maternity insurance contribution rate to the maternity insurance fund decays with time giving a long-run limited impact in both provinces. Thus the positive impact is stronger in the short term, but in the long term, its influence or contribution to stability of the funds reduces. The positive impact of interest from investment in the maternity insurance fund is however insignificant in both provinces, giving a major cause for concern on its role in maternity insurance fund income generation. In the short term, the contribution rate of the maternity insurance fund must be adjusted upward or the payment base expanded to receive additional contribution from all employees to avoid complete depletion of the fund. In the long term, we recommend the need to replenish the maternity insurance funds through proper investment options for the funds. We further recommend the need to look for other sources of funding social interventions based on existing practices in other countries.

scholarly journals The second pregnancy has no effect in the incidence of macrosomia: a cross-sectional survey in two western Chinese regions

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Li Luo ◽  
Huan Zeng ◽  
Mao Zeng ◽  
Xueqing Liu ◽  
Xianglong Xu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Western China ◽  
Fetal Macrosomia ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Second Child ◽  
Child Policy ◽  
Significant Difference ◽  
The Impact

Abstract Background After the implementation of the universal two-child policy in China, the increase in parity has led to an increase in adverse pregnancy outcomes. The impact of one and two fetuses on the incidence of fetal macrosomia has not been fully confirmed in China. This study aimed to explore the differences in the incidence of fetal macrosomia in first and second pregnancies in Western China after the implementation of the universal two-child policy. Methods A total of 1598 pregnant women from three hospitals were investigated by means of a cross-sectional study from August 2017 to January 2018. Participants were recruited by convenience and divided into first and second pregnancy groups. These groups included 1094 primiparas and 504 women giving birth to their second child. Univariate and multivariate logistic regression analyses were performed to discuss the differences in the incidence of fetal macrosomia in first and second pregnancies. Results No significant difference was found in the incidence of macrosomia in the first pregnancy group (7.2%) and the second pregnancy group (7.1%). In the second-time pregnant mothers, no significant association was found between the macrosomia of the second child (5.5%) and that of the first child (4.7%). The multivariate logistic regression model showed that mothers older than 30 years are not likely to give birth to children with macrosomia (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.4,0.9). Conclusions The incidence of macrosomia in Western China is might not be affected by the birth of the second child and is not increased by low parity.

Rangeland responses to pastoralists' grazing management on a Tibetan steppe grassland, Qinghai Province, China

2016 ◽  
Vol 38 (1) ◽  
pp. 1 ◽  
Author(s):  
Richard B. Harris ◽  
Leah H. Samberg ◽  
Emily T. Yeh ◽  
Andrew T. Smith ◽  
Wang Wenying ◽  
...  
Keyword(s):  
Plant Species ◽  
Temporal Trends ◽  
Winter Season ◽  
Grazing Pressure ◽  
Livestock Grazing ◽  
Western China ◽  
Permanent Plots ◽  
Sheep Grazing ◽  
Qinghai Province ◽  
Preferred Species

Livestock grazing is the principal land use in arid central Asia, and range degradation is considered a serious problem within much of the high-elevation region of western China termed the Qinghai-Tibetan Plateau (QTP). Rangeland degradation on the QTP is variously attributed to poor livestock management, historical-cultural factors, changing land tenure arrangements or socioeconomic systems, climate change, and damage from small mammals. Few studies have examined currently managed pastures using detailed data capable of isolating fine-scale livestock–vegetation interactions. The aim of the study was to understand how differences among livestock (primarily sheep) management strategies of pastoralists during winter affected subsequent rangeland condition and productivity. Plant species composition, annual herbage mass, and indicators of erosion were quantified during four summers (2009–2012) on winter pastures managed by 11 different pastoralists on QTP steppe rangeland in Qinghai Province, China. Data came from repeated-measurements on 317 systematically located permanent plots, as well as pastoralist interviews and the use of GPS-equipped livestock. Relationships between annual weather variation and herbage mass were modelled using an independent set of vegetation measurements obtained from livestock exclosures. Account was taken of inherent site differences among pastures. Annual variation in herbage mass was found to be best fitted by a model containing a negative function of winter-season temperature and a positive function of spring-season temperature. Accounting for annual and site effects, significant differences among pastoralists were found for most response variables, suggesting that individual heterogeneity among management approaches had consequences, even among neighbouring pastoralists. Annual herbage mass of preferred plant species was positively associated, whereas that of unpreferred species was negatively associated, with mean sheep density and intensity of use. However, the proportion of bare soil, an index of erosion, and annual herbage mass of unpreferred forbs were found to have positive relationships with sheep grazing pressure during the preceding winter, whereas live vegetation cover and annual herbage mass of preferred grasses were negatively related. Thus, on a spatial scale, pastoralists responded adaptively to the cover of preferred plant species while not responding to total annual herbage mass. Pastoralists stocked pastures more heavily, and livestock used regions within pastures more intensively, where preferred species had a higher cover. However, where sheep grazing pressure was high, downward temporal trends in the herbage mass of preferred species were exacerbated. Pastures that were stocked at a lower density did not experience the negative trends seen in those with a higher density.

Maternal health services in China’s western rural areas: uptake and correlates

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Chengfang Liu ◽  
Linxiu Zhang ◽  
Yaojiang Shi ◽  
Huan ZHOU ◽  
Alexis Medina ◽  
...  
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Services ◽  
Health Systems ◽  
Uptake Rate ◽  
Rural Areas ◽  
Design Methodology ◽  
Maternal Health Services ◽  
Western China ◽  
Public Health Systems

Purpose Many public health systems have struggled with the dual questions of (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it. The objective of this study is to assess the uptake rate of a new set of maternal health services in poor rural areas of China. Design/methodology/approach The analysis is based on the survey responses of women’s representatives and village cadres from almost 1000 villages in June 2012 as part of a wide-scale public health survey in Sichuan, Gansu and Yunnan provinces in the western part of China. Findings We find that the uptake rate of maternal health services (including in-hospital delivery, antenatal care visits and post-partum care visits) in poor rural areas of western China are far below average in China, and that the rates vary across provinces and ethnic groups. Our analyses demonstrate that distance, income, ethnicity and availability appear to be systematically correlated with low uptake rates of all maternal health services. Demand-side factors seem to be by far the most important sources of the differences between subpopulations. We also find that there is potential for creating a Conditional Cash Transfer program to improve the usage of maternal health services. Originality/value We believe that our results will contribute positively to the exploration of answers to the dual questions that many public health systems have struggled with (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it.

scholarly journals WILLINGNESS TO BE VACCINATED AGAINST COVID-19 AMONG HIGHER EDUCATION INSTITUTION

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Joel Rey Acob ◽  
Moises Neil V. Seriño ◽  
Reyvin N. Sabanal ◽  
Therese C. Ratilla ◽  
Elwin Jay Yu ◽  
...  
Keyword(s):  
Medical Profession ◽  
Education Institution ◽  
Faculty Members ◽  
Descriptive Statistics ◽  
Pharmaceutical Companies ◽  
Health Crisis ◽  
Beneficial Effects ◽  
Convenience Sampling ◽  
Increase Success Rate ◽  
Selection Of

Background: The increasing COVID-19 cases worldwide ignite pharmaceutical companies’ effort to discover safe vaccines have been eyed globally. Informed perspectives across medical profession explaining beneficial effects of inoculation, however, various personal views persist which lead to confusion among general public. Objectives: To describe demographic characteristics among education institutions and their willingness to be vaccinated. Methods: Data were collected by google forms, in February 2021. The online form was then pre-tested on 10 respondents to refine questions prior to commencing the survey. Convenience sampling was administered for the selection of voluntary respondents. Data cleaning was done prior to the data analysis. Recoding of string variables and omittion of invalid responses were also done. Descriptive statistics was undertaken in a genuine licensed software of IBM SPSS Statistics version 26. Results: A total of 401 respondents answered the survey. More than half of the respondents are female constituting 62.1% of the sample, whereas males constitute 37.9%, mostly faculty members, single (63.1%), earning 20,000 (54.2%) per month. More than half of the respondents are willing to get vaccinated against COVID-19 (54.6%) and have no preference for a specific type of COVID-19 vaccine (54.9%). Around 30.4% are still unsure if they should get vaccinated or not and 15% have indicated negatively. Comparing both sexes, a larger frequency of males is willing to get vaccinated constituting 69.1% and females (45.8%). Conclusion: Males showed more willingness to be inoculated regardless of COVID-19 vaccine types. Education and continuous campaign on the importance of vaccination program is a must to increase success rate to end the health crisis.

scholarly journals Socioeconomic inequalities and determinants of maternal health services in Shaanxi Province, Western China

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0202129 ◽  
Author(s):  
Ruo Zhang ◽  
Shanshan Li ◽  
Chao Li ◽  
Doudou Zhao ◽  
Leqian Guo ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Health Services ◽  
Socioeconomic Inequalities ◽  
Shaanxi Province ◽  
Western China

Trends in Cesarean Delivery Rate after Cessation of the One-Child Policy in China

2020 ◽  
Author(s):  
Xiaohua Liu ◽  
Ding Huang ◽  
Mark B. Landon ◽  
Weiwei Cheng ◽  
Yan Chen
Keyword(s):  
Cesarean Delivery ◽  
Chinese Population ◽  
Contribution Rate ◽  
Term Pregnancy ◽  
Robson Classification ◽  
One Child Policy ◽  
Nulliparous Women ◽  
Child Policy ◽  
Scarred Uterus ◽  
The One

Abstract Objective We aimed to describe changes in cesarean delivery (CD) rates after the change of the one-child policy in China by using the Robson classification in a large Chinese population. Study Design This retrospective cohort study included 91,015 women who delivered at ≥24 weeks of gestation at a large tertiary obstetric center in Shanghai, China from 2011 to 2016. We analyzed CD rate trend and CD contribution trend in each Robson group. Logistic regression was used to calculate the odds of CD while adjusting for confounding variables. Results The overall CD rate decreased from 49.0% in 2011 to 40.6% in 2016. In nulliparous women with singleton cephalic term pregnancy and planned CD, the CD contribution rate was reduced significantly from 29.3% in 2011 to 16.4% in 2016 (p < 0.001). In multiparous with a scarred uterus, the CD contribution rate began to increase from 3.8% in 2011 to 9.1% in 2016 (p < 0.001). Compared with delivery in 2011, delivery in 2016 was associated with a 37% (adjusted odds ratio [aOR]: 0.63; 95% confidence interval [CI]: 0.60–0.66) reduction in CD. This reduction was observed in both nulliparous women with singleton cephalic term pregnancy (aOR: 0.57; 95% CI: 0.54–0.60), and multiparous women with singleton cephalic term pregnancy without scar (aOR: 0.41; 95% CI: 0.30–0.55). Conclusion The rate of cesarean delivery in our Chinese population has declined significantly in the past few years.

scholarly journals Bolstering Maternity Insurance to Support Family Health of Ethnic-Minority Women under Universal Two-Child Policy: Empirical Evidence from China’s Ningxia-Hui Autonomous Region

2020 ◽  
Author(s):  
Henry Asante Antwi ◽  
Lulin Zhou ◽  
Maxwell Opuni Antwi ◽  
Ama Boafo-Arthur ◽  
Tehzeeb Mustafa
Keyword(s):  
Post Partum ◽  
Family Health ◽  
Fund Raising ◽  
Insurance Fund ◽  
Autonomous Region ◽  
Child Policy ◽  
Child Bearing ◽  
Ningxia Hui Autonomous Region ◽  
Utilisation Rate ◽  
Sentinel Event

Abstract Background Despite the overwhelming feeling of great happiness, joyful excitement and rituals that heralds the arrival of a child, for too many women (especially in developing countries), child bearing is associated with suffering, ill health and even death. The need to consolidate and support women to procreate in tranquillity has inspired international and domestic agencies to harness the resources at their disposal to protect the health of women especially during pregnancy, child birth and the post-partum period. Methods The study applied a systems dynamic model to selected data to establish the influence of the universal two-child policy in China on maternity insurance fund income. The study also established sensitivity analysis of the appropriate rate of contribution to keep the fund active. Results The study revealed that increases in utilisation rate as results of increase in number of births under the universal two-child policy increased the accumulated deficit of the maternity insurance fund income in the Ningxia-Hui Autonomous Region. At the current rate, the entire fund will be depleted by the end of 2021 unless the contribution rate is increased from 0.5% to 0.75%. Conclusions Maternal health is a “sentinel event” requiring an unprecedented global resource mobilisation to safeguard the future of humanity. Thus maternity insurance schemes in China require new methods of fund raising to keep a sustainable maternity insurance fund in the region. Study also reveals that population reform is not done in isolation but require changes in the fundamental social structures to ensure its sustainability.

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