Prevalence of depressive symptoms and correlated factors among pregnant women during their second and third trimesters in northwest rural China: a cross-sectional study

Background The depression mood during their second and third trimesters has a negative impact on both the mother and her child. Compared with pregnant women in urban areas, rural pregnant women who are in more disadvantaged situation may have more serious psychological problems. Particular, many rural pregnant women had internal migrant work experience during pregnancy in rural China. It is thus necessary to study the prevalence of depressive symptoms and correlated factors among Chinese northwest rural pregnant women. Methods This study was conducted from October 2017 to April 2018 and surveyed 1053 pregnant women in the middle and late stages of pregnancy who were registered in rural areas, gave informed consent and did not suffer from cognitive impairment or severe mental illness. Depressive symptoms were evaluated by the Chinese Version of the Short Depression Anxiety and Stress Scale (DASS-C21). Demographic characteristics, pregnancy characteristics and family factors were obtained through structured questionnaires. This study employed multiple factor logistic regression to analyze the relationship between depressive symptoms and their correlates. Results The prevalence of depressive symptoms among pregnant women during their second and third trimesters was 16.14% (95%CI 13.92%-18.36%). Higher education levels (OR = 0.50; 95%CI 0.29–0.85) and taking folic acid (OR = 0.59; 95%CI 0.39–0.89) reduced the risk of depression symptoms. The family receiving rural welfare (OR = 1.69; 95%CI 1.04–2.75), migration for work (OR = 1.95; 95%CI 1.03–3.71) and living with both parents and parents-in-law (OR = 2.55; 95%CI 1.09–5.96) increased the risk of depressive symptoms. Conclusions The prevalence of depressive symptoms among pregnant women during their second and third trimesters in Northwest rural China was 16.14% that was nearly 4 percentage points higher than the average survey result of the pregnant women in developed countries and was higher than the findings in Chinese urban areas. To prevent depression symptoms, it’s essential to early screen and provide folic acid for free when antenatal examination. Moreover, maternal examination files should be established so that wo pay attention to the psychological status of pregnant women who were with low education levels, poor family economic situations, excessive parental burden and who had been migrant workers.

Hospital management practices in county-level hospitals in rural China and international comparison

Background Although management is important in healthcare, low- and middle-income countries (LMICs) have little experience measuring the competence of hospital management. While improving hospital management is the main focus of hospital reform in China, few studies have empirically documented the baseline situation to inform policy design. Methods We assessed the management practices of county-level hospitals in Guizhou in southwest China during 2015. We used the Development World Management Survey (D-WMS) instrument to interview 273 managers in 139 hospitals. We scored the management practices of the sampled hospitals, overall and in four dimensions (operations, monitoring, targets, personnel management) and three processes (implementation, usage, monitoring). We then converted the scores to the WMS scale and compared these with data from two other LMICs and seven high-income countries (HICs). Results On a scale of 1 (‘worst practice’) to 5 (‘best practice’), the mean (SD) hospital D-WMS scores were 2.57 (0.46) overall; 2.71 (0.48), 2.64 (0.58), 2.40 (0.64), and 2.56 (0.40) for operation, monitoring, target, and personnel, respectively; and 2.43 (0.48), 2.62 (0.48), and 2.66 (0.47) for implementation, usage, and monitoring, respectively. After conversion to WMS scores, China ranked seventh of 10 countries, after six HICs and higher than one HIC and two other LMICs (Brazil and India). China ranked higher than the two LMICs in each of the four dimensional scores. Conclusions Chinese county-level hospitals should improve their low quality of management by prioritizing target-setting and process implementation, particularly in personnel management. Meanwhile, modern management training should be given to most clinical managers.

Bullying Victims in Rural Primary Schools: Prevalence, Correlates, and Consequences

School bullying is a widely recognized problem in developed countries, but remains under-investigated in developing countries, especially in remote rural areas. In this paper, we examine the prevalence, correlates, and consequences of bullying victimization and its relation to educational performance and creative attitudes. Using data from 10,528 students across 120 primary schools in rural China, we find an alarmingly high prevalence of bullying victimization and that several individual, family, and school characteristics are correlated with bullying victimization. Analyses indicate students who are bullied frequently score lower in Chinese, reading, and math tests and creative attitudes. Taken together, the results demonstrate a need for further research and policy interventions to reduce bullying in schools.

Institutional Differences in Individual Wellbeing in China

An imbalanced distribution of income and welfare characterizes a developing or transitional economy such as China’s. Even after forty years of reform and rapid economic growth, there is still considerable disparity in wellbeing across different institutional settings in China. Major inequalities exist between rural and urban areas, public and for profit sectors, and state-owned and private enterprises. This paper presents the descriptive differences in individual wellbeing across these kinds of institutional settings from objective and subjective perspectives, enabled by the five waves of the Chinese General Social Survey (CGSS; the years of 2010, 2011, 2012, 2013 and 2015). The results show that: (1) people in urban China enjoy more objective wellbeing than people in rural China, but less subjective wellbeing; (2) people who work for the public sector enjoy more objective and subjective wellbeing than those for the for profit sector; (3) people who work for the state owned enterprises enjoy more objective wellbeing than those for the for profit sector, but subjective happiness is not significantly different. Furthermore, people’s perception of subjective wellbeing not only relies upon substantive objective wellbeing, but also an affiliation with a certain type of institution.

Maternal educational inequalities about adverse pregnancy outcomes observed in a rural area of a province of China during a time period (2010–2018)

BackgroundThe relationship between maternal education and adverse pregnancy outcomes is well documented. However, limited research has investigated maternal educational disparities in adverse pregnancy outcomes in China. This study examined maternal educational inequalities associated with adverse pregnancy outcomes in rural China.MethodsWe conducted a population-based cohort study using participants enrolled in the National Free Preconception Health Examination Project in Yunnan province from 2010 to 2018. The primary outcome was stillbirth, and the secondary outcome was adverse pregnancy outcomes, defined as a composite event of stillbirth, preterm birth or low birth weight. The study was restricted to singleton births at 20–42 weeks’ gestation. Univariate and multivariate log-binomial regression models were performed to estimate crude risk ratios (RRs) and confounding-adjusted RRs (ARRs) for stillbirth and adverse pregnancy outcomes according to maternal education level.ResultsA total of 197 722 singleton births were included in the study. Compared with mid-educated women, low-educated women were at a significantly increased risk of stillbirth (ARR, 1.20; 95% CI, 1.05 to 1.38) and adverse pregnancy outcomes (ARR, 1.11; 95% CI, 1.07 to 1.16). However, the risk of stillbirth (ARR, 1.16; 95% CI, 1.01 to 1.35) was significantly higher for high-educated women compared with mid-educated women.ConclusionCompared with women with medium education level, women with lower education level were more likely to experience adverse pregnancy outcomes, including stillbirth, and women with higher education level were more likely to experience stillbirth.

SOCIO-ECONOMIC FACTORS AND CROP PRODUCTION EFFICIENCY IN CHINA AND ETHIOPIA: A REVIEW

The main challenge of agriculture is to ensure food security in line with yield increases and minimize environmental costs due to complex interactions between social, economic, and ecological factors. Here we review to identify the impacts of socio-economic factors on crop production efficiency between China and Ethiopia. To set the economic reform and improve the grain yields in rural China, a series of policies on land reforms from communal systems to tax cancelation and subsidies have been implemented. Similar to China, Ethiopia has also experienced different types of land reform from landlord and peasant structure to land as the common property of nations, nationalities, and peoples of Ethiopia. The Gross Domestic Products per capita trends which represent the mean standard of leaving of residents in a country show almost similar growth in the 1980s while later significant variation was achieved between the two countries. It is suggested that to meet food security and increase agricultural efficiency in Ethiopia better infrastructure development that meets socio-economic demands should be prioritized while in China policies to reduce fertilizer inputs are highly recommended to minimize the environmental costs due to high agricultural inputs for sustainable agriculture growth.