Open Access Open Badges Research article

Measuring and decomposing the inequality of maternal health services utilization in Western Rural China

Xiaoning Liu12, Wenlong Gao12 and Hong Yan1*

Author Affiliations

1 Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University College of Medicine, P.O Box 46, No.76 West Yanta Road, Xi’an, Shaanxi 710061, China

2 Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China

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BMC Health Services Research 2014, 14:102  doi:10.1186/1472-6963-14-102

Published: 3 March 2014



To measure socioeconomic inequalities in maternal health services in rural western China and to analyze the determinants’ contributions of inequalities.

Study design: a cross-sectional study.


The data utilized in this study were obtained from a cross-sectional study from 10 provinces in rural Western China in 2005. Wealth index of household socioeconomic status was developed by using principle component analysis. Concentration index, concentration curve and decomposition of the concentration index were employed to measure socioeconomic inequality in maternal health services utilization.


For more than four times prenatal visits, the concentration index was 0.0605 (95% CI: 0.0603, 0.0607). The concentration index of hospital delivery was 0.0230 (95% CI: 0.0210, 0.0240) and the concentration index of more than 2 times postnatal visits was 0.0842 (95% CI: 0.0836, 0.0847). Han ethnicity woman, particularly in conjunction with high school education and rich wealth status, was the main contributor to inequality in maternal health services utilization.


There is a strong pro-rich inequality of maternal health services in rural western China. This study suggests that an effective way to reduce the inequality is not only to narrow the gap of income between the rich and poor, but focus education on ethnic minority woman in rural remote areas.

Maternal health care utilization; Rural Western China; Socioeconomic inequality; Decomposition