Northwest China's Qinghai Province has launched a pilot program -- the first in the country -- to reduce mother and infant mortality rates in impoverished rural areas.

Zhoema, a herder's wife, was one of the first beneficiaries of the program in Guinan County. She paid 50 yuan (US$6) last year to be registered in the healthcare program. When she gave birth at a local hospital in Senduo Village last week, midwifery services, medicine and basic vaccinations cost virtually nothing.

"We couldn't have afforded to have the baby at a hospital if it weren't for this program," said Zhoema. "Even a normal delivery costs about 200 yuan (US$24), which is more than a tenth of our annual earnings."

Childbirth remains a life-and-death challenge for farming and herding women in some outlying areas of Qinghai. Often desperately poor and with little access to medical facilities even if they want them, many simply cannot afford professional care.

"Most herders' wives give birth at home, and an average of 2 out of 10 newborn babies died before the healthcare program became available in September 2003," said He Minglu, a doctor at the Senduo Village hospital.

Guinan County was one of the first eight selected by the provincial government to test the program.

More women have been encouraged and enabled to go to hospital to give birth this year. The program covers almost all the expenses in a normal childbirth and part of the expenses if there are complications, such as a Caesarean delivery.

In Guinan alone, the mortality rates of mothers and newborns have dropped by 46 percent and 40 percent, according to the county's health bureau. Actual numbers were not provided.

In Gangcha County, a pilot county in the northeastern part of the province, 82 percent of expectant mothers now prefer to give birth at hospitals.

"The efforts have proven effective in relieving the herders' burden and ensuring the safety of women and their babies," said Li Xiuzhong, an official with the Qinghai Provincial Health Bureau.

Qinghai, the second most impoverished province in China, has unusually high maternal and infant mortality rates, according to a UNICEF report. Bound by tradition, many women choose not to give birth in a hospital even if they can afford it, and their family members do not possess sufficient knowledge to handle delivery complications or problems in newborn babies.

Nationwide, the maternal mortality rate fell from 89 per 100,000 live births in 1990 to about 53 per 100,000 live births a decade later, according to UNICEF, but with variations rising as high as threefold between areas.

(China.org.cn, China Daily November 2, 2004)