Promoting contraceptive use among female rural-to-urban migrants in Qingdao, China: a comparative impact study of worksite-based interventions.

BACKGROUND: We conducted a comparative study in worksites to assess the impact of sexual health promoting interventions on contraceptive use among female rural-to-urban migrants. STUDY DESIGN: In Qingdao ten manufacturing worksites were randomly allocated to a standard package of interventions (SPI) and an intensive package of interventions (IPI). The interventions ran from July 2008 to January 2009. Cross-sectional surveys at baseline and end line assessed the sexual behaviour of young female migrants. To evaluate the impact of the interventions we assessed pre- and post-time trends. RESULTS: From the SPI group 721 (baseline) and 615 (end line) respondents were considered. Out of the IPI group we included 684 and 603 migrants. Among childless migrants, self-reported contraceptive use increased significantly after SPI and IPI (adjusted odds ratio [aOR] = 3.23; 95% confidence interval [CI] = 1.52-6.84; p < 0.01 and aOR = 5.81; 95% CI = 2.63-12.80; p < 0.001, respectively). Childless migrants older than 22 years reported a greater use after IPI than after SPI. CONCLUSION: Implementing current Chinese sexual health promotion programmes at worksites is likely to have a positive impact on migrant women working in the manufacturing industry of Qingdao. More comprehensive interventions seem to have an added value if they are well targeted to specific groups.

Promoting contraceptive use more effectively among unmarried male migrants in construction sites in China: a pilot intervention trial.

Poor sexual and reproductive health status has been reported among rural-to-urban migrants in China. Therefore, some effective and feasible interventions are urgently needed. The authors developed a workplace-based intervention to compare 2 young labor migrant service packages (A and B) on the knowledge, attitude related to contraception, and contraceptive use among unmarried male migrants in Chengdu. Fourteen construction sites were randomly assigned to either of the 2 intervention packages. Interventions were completed in 3 months, and data were collected in 2 rounds independently (before and after interventions). After the intervention, the median scores for knowledge and attitude in migrants in package B were significantly higher than in migrants in package A. Although migrants in both packages increased use of condom, the increase was pronounced in migrants in package B, with odds ratio (OR) = 9.65 (95% confidence interval [CI] = 1.41-66.28). The rate of unwanted pregnancies was reduced more significantly in migrants in package B than in migrants in package A (OR = 0.16; 95%CI = 0.03-0.45). Unmarried male migrants who received the comprehensive intervention (package B) were more willing to use condoms and avoid unwanted pregnancies effectively.

Determinants of unmet need for contraception among Chinese migrants: a worksite-based survey.

BACKGROUND: Considerable sexual and reproductive health (SRH) challenges have been reported among rural-to-urban migrants in China. Predictors thereof are urgently needed to develop targeted interventions. STUDY DESIGN: A cross-sectional study assessed determinants of unmet need for contraception using semi-structured interviews in two cities in China: Guangzhou and Qingdao. RESULTS: Between July and September 2008, 4867 female rural-to-urban migrants aged 18-29 years participated in the study. Of these, 2264 were married or cohabiting. Among sexually-active women (n = 2513), unmet need for contraception was reported by 36.8% and 51.2% of respondents in Qingdao and Guangzhou, respectively; it was associated with being unmarried, having no children, less schooling, poor SRH knowledge, working in non-food industry, and not being covered by health insurance. A substantial proportion of unmarried migrants reported they had sexual intercourse (16.6 % in Qingdao and 21.4% in Guangzhou) contrary to current sexual standards in China. CONCLUSION: The study emphasises the importance of improving the response to the needs of rural-to-urban migrants and recommends strategies to address the unmet need for contraception. These should enhance open communication on sexuality, increase the availability of condoms, and improve health insurance coverage.

Mifepristone-induced early abortion and outcome of subsequent wanted pregnancy.

Follow-up information on subsequent pregnancies after mifepristone (RU486)-induced abortion is scarce. The authors examined whether one mifepristone-induced first-trimester abortion affects the outcome of a subsequent wanted pregnancy. In a study conducted in 1998-2001 at antenatal clinics in Beijing, Chengdu, and Shanghai, China, the authors enrolled 4,925 women with no history of induced abortion, 4,931 women with one previous mifepristone-induced abortion, and 4,800 women with one previous surgical abortion and followed them through pregnancy and childbirth. The adjusted odds ratio for preterm delivery in women with one mifepristone abortion compared with women with no abortion was 0.77 (95% confidence interval: 0.61, 0.98). Although the mean birth weight of infants born to women with mifepristone abortion was 33 g (95% confidence interval: 17, 49) higher than that of infants born to women with no abortion, the frequencies of low birth weight and mean lengths of pregnancy were similar. There were no significant differences in risk of preterm delivery, frequency of low birth weight, or mean infant birth weight in the comparisons of women with previous mifepristone abortion and women with surgical abortion. This study suggests that one early abortion induced by mifepristone in nulliparous women has no adverse effects on the outcome of a subsequent pregnancy.

[Study on the occurrence of cesarean section (CS) and factors related to CS in China].

OBJECTIVE: To find out the occurrence of cesarean section (CS) and to probe the factors associated with CS. METHODS: Women with CS as "case group" and women without CS as "control group" were chosen in a case-control study. RESULTS: Among 14 071 childbirth women, 6 421 had CS (case group) with the occurrence rate of 45.6% and 7 650 (54.4%) had normal delivery (control group). In comparison with the control group, the CS group had following several higher rates [with significant differences between case group and control group (P < 0.01)]: well-educated (78.9% vs 69.5%), white collar jobs (38.0% vs 32.3%), urban residents (79.1% vs 70.6%), high monthly income (>/= 500 Yuan) (81.0% vs 70.6%), of older age (>/= 25 years) (73.3% vs 63.0%), heavier baby weight (> 4 000 gram) (8.3% vs 2.9%), male babies (53.9% vs 51.4%), BMI of mother (> 24) (8.8% vs 4.8%), cephalopelvic disproportion (21.1% vs 0.9%), intrauterine asphysia (20.3% vs 6.7%), abnormality of force of labor (4.2% vs 2.7%), prolonged labor (2.9% vs 1.0%) and placenta previa (1.4% vs 0.4%). Our study also indicated that the higher the educational level was, the higher the rate of CS appeared; and the older the pregnant women was, the higher the rate of CS was. In CS group, over 70% primipara were over 24 years, and over 20% primipara had cephalopelvic disproportion and over 20% had intrauterine asphysia in CS group. CONCLUSIONS: At present, the occurrence rate of cesarean section was rather high (45.6%) in China. The high rate of CS was more likely to associate not only with abnormal physiological/medical factors (eg. cephalopelvic disproportion, intrauterine asphysia, abnormality of force of labor, and prolonged labour, etc.), but also with some demographic factors as education, occupation, income and age, etc. It is necessary to take measures to reduce the unnecessary CS in China.