| BackgroundPopulation flows is close related to globalization, the economic development, society and economic disparity. Shanghai is going to reach the goal of "four centers" which included with international economic, financial, trading and shipping center construction; We are seeing more International communication and the cooperation, competitions and activities with other countries along with the reform of Chinese economic system, especially after accession to WTO. which attracting a large number of foreign talents to work and live in Shanghai. The latest figures from Shanghai statistics Bureau showed the number of expatriates in Shanghai is already ranked first in China, foreign population in Shanghai has reached152,100people by the end of2010, accounting for0.8%of the resident population; the foreign resident’s age range from30to59years nearly55.9%during the total foreign population.Therefore, diversified demands of healthcare services have derived from the foreigners. So the medical and health care services in Shanghai should meet the diversified needs in line with the international standards; while the foreigners especially for the pregnancy women are exactly far away from their hometown, family and friends. They may not familiar with the living environment, cultural differences, values, language, and totally new to the maternal and child health care institutions, although some of the local hospitals have set up the collaboration project of claims settlement service with the insurance company or the third party agency which in order to facilitate the foreigners live and work in Shanghai. They don’t need to pay cash during the time in Shanghai after the corresponding health care services, and the fees are directly settled account between the relevant insurance companies or third party insurance agency and medical institutions, but so far even in Shanghai as is an international metropolis still has less health care institutes which can provide the qualified maternal healthcare services for the foreigners.Shanghai has good reputation and stay in a leading position on the maternal and infant management and service, but with the rapid increase of floating population in Shanghai, especially when the maternal death of floating population was presented to be90%of the native Shanghainese, it would be a serious challenge for Shanghai to improve this kind of situation and also has the urgent need to explore suitable service and management model for floating women in Shanghai in order to break through the "bottleneck" to reduce the city’s maternal mortality rate. As the requirement of WHO "Safe motherhood", the government in Shanghai took a lot of efforts to set up more fix delivery hospitals for floating women, increased floating women utilizing the facilities of maternal and infant, improved the quality of healthcare service.But for the expatriates, especially foreign maternal this special population group, it is not retrieved any researches from China focus on foreign women reproductive healthcare services, the demands of prenatal education and the service model of exploration and research. Due to language barrier, cultural differences, unfamiliar with the environment, healthcare organizations and service models, foreign pregnant women have fewer choices among the joint venture hospitals, private hospitals and VIP clinical in public teaching hospital. So this paper will be necessary and significant to focus on foreign pregnant women based on the present situation of pregnant women in Shanghai. Explore if foreign pregnant women would enjoy continuous and high quality prenatal care services in Shanghai just as the same as their home countries, it also can provide some reference and suggestion for Shanghai to construct comprehensively international medical community, the introduction of international and domestic high-quality medical resources, and make Shanghai become an international standard, matched to the medical and health service system and the Asian first-class medical center which reflect the characteristics of Shanghai in order to meet the diversified and multi-level social demands.ObjectiveThrough survey and analyze the prenatal education demands among foreign pregnant women, to design and implement the prenatal education, to provide the references of countermeasures and suggestions for setting up the related policies based on the evaluation the education efficacy, We will try to explore and promote the appropriate pregnancy health education and service model for foreign pregnant women, finally to improve the quality of foreign pregnancy health care.Contents and MethodsAll the foreign primiparous women were included after signing an informed consent form, exploring the acquaintance degree of pregnancy care knowledge and understanding of the needs for pregnancy health education in foreign primiparous women. Expert consultation has been used to design the questionnaire in English version, Literature review and individual interview was used to collection the data on the situation of education demand and education effect regarding foreign pregnancy women.Qualitative combine quantitative methods, for instance, literature review, expert consultation, group discussion and health statistic methods are applied to collect data in this study. The health statistic methods have been used to analyze the prenatal education content demand and degree of foreign pregnancy women, also used to evaluation the efficacy of the training course designed for targeted foreign pregnancy women, such as we analyzed the data with SPSS17.0software package and tested the statistical significance with mean, absolute frequency, X2test and T test. According to the foreign pregnancy women’s needs of pregnancy health education, we selected effective way and designed targeted courses for foreign pregnancy women and implemented regularly. Finally, individual interviews which was used to evaluate the effect of prenatal education and satisfaction of foreign pregnancy women. After recorded in the process the materials were transcribed and analyzedMain results1.The current situation of foreign pregnant women in Shanghai.The survey showed only had36.8%foreign pregnant women in the Best child-bearing age range which during25to30years old, because it was recognized as the24-30years for the best child-bearing age according to the practice of medicine and the large amount of data analysis.Foreign pregnant women have high education lever in general of this study; most of them come from education of developed country such as Europe and America, which is inconsistent with previous domestic literatures on the floating population with low education lever. Most of Foreign women tend to choose the service provided by the maternal and child health care institutions which has been set up direct billing cooperation with various international assurance company or third party insurance agency, but some of them no international insurance usually go back to their own countries to get pregnancy care services.2. Foreign pregnant women how to get information about hospitals and medical staff.Findings shows,82%foreign pregnant women gets hospital and medical staff s information through the Internet, especially the blog in" Shanghai mamas" website has high popularity, and they can also got information from government websites, friends or domestic service personnel or some foreign periodical magazine, They are tend to choose doctors and midwives with foreign work or training experiences.3. The demands of prenatal health education on foreign pregnant womenThe demands order of prenatal health education can be to visit wards, operation room and neonatal delivery room, knowledge of neonatal vaccination, oral health care knowledge, pregnancy nutrition knowledge and guidance, basic knowledge of medication during pregnancy, maternal psychological adjustment and relaxation techniques, maternal fetal education knowledge guidance, natural childbirth knowledge and skills for pain relief, simulated childbirth, newborn basic nursing instruction, exercises during pregnancy, family self monitoring method, breastfeeding knowledge and skills, postpartum complications of hemorrhage and blood transfusion safety, knowledge on rehabilitation and postpartum contraceptive. The oral health care has caused enough attention in foreign pregnant women. Some domestic surveys show that domestic pregnant women pay more attention to fetal development, individual health status and neonatal scientific feeding knowledge and skill.4. The diversified choice of prenatal education among foreign pregnant womenThe order of selecting prenatal education manner as follow, the most popularity education way is attending the prenatal training course that provided by professional medical staff with overseas work experience, although foreign pregnant women have different nationalities, but they enjoy join in training courses together, they can know each other, share experience, even become a close friend, each lesson attendance rate reach to99%, practice indicated it had major significance for inviting family members or spouses of pregnant women to attend some training courses which related pregnancy exercise and prenatal psychological adaptation and relax skills, it is not only achieve the effect of health education but also can intimate emotion and adjustment pregnant women’s attitude, improve the ability to adapting; interpersonal demonstration and instruction by professional attending doctor which is an effective way of health education, its service model is worth to popularization; Internet advertising is another important way to receive health education knowledge for the modern women; English version brochures and journals are also quite important way to get health education information.5. Comparison the efficacy before and after receiving health education of foreign pregnancy women.The effective way for foreign pregnant women is to attending training courses to receive comprehensive, systematic, scientific knowledge of prenatal care. Regarding to grasp knowledge degree has significant changes before and after foreign pregnancy women receiving prenatal health education, such as self-monitoring during pregnancy, parturition pain relief method, breast care, breastfeeding techniques, neonatal nursing knowledge and skills, abnormal timely treatment during pregnancy, clinical practice showed foreign pregnant women’ s family members or spouse accompany participation in to accept the education effect were better than none the family members or husband took part into the training courses, such as exercise during pregnancy, natural pain relief techniques for labor, neonatal care and breastfeeding techniques to implement better than none the family members or husband accompany.Conclusions1. It showed that there was fewer organizations of Maternal and Children’ s health care which can provide qualified services to foreign pregnancy women, so far, existing maternal health care system can’ t improve the accessibility and convenience of MCH services.2. The leading demand of foreign pregnant women were to visit wards, operation room and neonatal delivery room, they also concerned about the knowledge of neonatal vaccination and vaccination types. It is suggesting that the licensing issues regarding import of urgently needed drugs which need appeal and strong support from all the relevant institutions3. Make efforts to integrate the limited resource of maternal health care service agencies especially with qualified experts in obstetrics and gynecology, neonatal pediatricians, pediatric care experts, psychologists, dentists, midwives, yoga instructors and sports coaches, nutritionists in foreign pregnant women, they can implement training courses for foreign pregnant women within the maternal and child health institutions or schools, in order to improve the quality of the training courses, sharing of resources, utilization and effectiveness4. To strengthen the management of foreign maternal and create actively a social environment of respecting for the floating population, explore and promote the appropriate pregnancy health education and service model for foreign pregnant women in China, finally to improve the quality of foreign pregnancy health care and achieve the ambitious goals of promoting the quality of the global population and international maternal and child health services. |
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