Investigation And Analysis On Puerperal Women’s Expectation And Status In Health Management Services

Background:Puerperal period is the vulnerable and critical period for puerperae and newborns,while they should be systematically managed.As the number of high-risk puerperae increasing after the "two-child" policy,the puerperal health management(PHM)services were facing more challenges.However,there were still many deficiencies in PHM services in China,resulting in low satisfaction of puerperae.It was urgent to optimize and improve the PHM services.Objectives:(a)Describe the expectations and perceptions of puerperae about PHM services;(b)describe the status quo of PHM services in community;(c)put forward suggestions for optimizing PHM services.Methods:The study was divided into two parts:the investigation on puerperae’s expectations and perceptions about PHM services and the investigation on the status quo of PHM services in community.In the first part,a questionnaire survey was conducted in the obstetrics clinic of a hospital in Beijing from April to June 2019,using the questionnaire developed by Delphi method.In the second part,the semi-structured interview method was conducted in 16 districts in Beijing.The health staff who undertook postpartum visit in their community were chosen as interviewee.Results:1.In the first part,a total of 699 valid questionnaires were collected.Among the 19 PHM services,17 of them showed statistical differences in the puerperae’s expectations and perceptions(all P<0.001).There was a significant gap between the expectations and perceptions in 6 PHM services:"guidance of caring for infants with common diseases","guidance of infant touching","guidance of breastfeeding","management of puerperae’s weight","assessment and guidance of taking care for infant",and"guidance of medication for puerperae".The type of household registration,parity were influencing factors of puerperae’s expectations on PHM services(F=5.671,P<0.001).The age,family income and main caregiver were influencing factors of puerperae’s perceptions on PHM services(F=6.862,P<0.001).2.In the second part,18 people were interviewed and 178,868 words were transcribed.Four themes were extracted:(a)lack of resources and information which resulted in lots of difficulties in the implementation of postpartum visit;(b)poor allocation and poor treatment for personnel who undertake postpartum visits;(c)poor quality of PHM,and inadequate services content;(d)inadequate social attention exacerbated by commercial institutions.Conclusion:There were significant gaps between puerperae’s expectations and perceptions of PHM,especially in "guidance of caring for infants with common diseases","guidance of infant touching"and other 4 services.Authorities should pay attention to it.There were four problems in community PHM services:lack of resources and information,poor allocation of human resources,poor quality of the services,and interference by commercial puerperal companies.These problems led to PHM services can not meet the expectations of puerperae,which should be paid attention to.