Disparities in awareness and utilisation of National Essential Public Health Services between the floating population and the registered residents: a cross-sectional study in China

Objective There are differences between the floating population and the registered population in the awareness and use of the National Essential Public Health Services (NEPHS) due to the influence of China’s household registration system. The Equalization of Basic Public Health and Family Planning Services (EBPHFPS) policy aims to reduce disparities among populations by enhancing the migrant population’s access to basic public health services. The aim of this study is to examine the relationship between the EBPHFPS targeted at the floating population and the disparities in access to and utilisation of NEPHS between registered residents and the floating population. Design A cross-sectional study. Setting 8 cities (regions, autonomous prefectures) in China. Participants 13 998 floating population and 14 000 registered residents in eight cities (regions, autonomous prefectures) were included in the analysis. Outcome measures Three binomial variables, including awareness of NEPHS, acceptance of health education and establishment of health records, were used as outcome indicators to examine the relationship between the EBPHFPS and the disparities between the floating and registered populations. Methods A linear regression model, fairness gap calculation and propensity score matching were used to explore the associations. Results The areas that implemented EBPHFPS exhibited an 8.3% increase in awareness of the NEPHS (p0.1). The floating population in the pilot areas of the policy encountered greater disparities in the establishment of health records (p<0.01). Conclusions Positive associations between the EBPHFPS policy and NEPHS awareness and utilisation among the floating population were demonstrated to some extent; however, the floating population was still confronted with a degree of inequality of opportunity. The government needs to develop target-oriented policies and a guaranteed mechanism to ensure access to NEPHS among the floating population.