A simple way to increase service use: Triggers of women's uptake of postpartum services

Abstract

Objective: To examine the socio-demographic and service-related determinants of utilisation of postpartum services. Design: Data were used from a single-blind, randomised controlled trial aimed at changing women's knowledge, attitude and behaviour regarding certain postpartum health issues by providing written information via a specially prepared booklet. Setting: Four private hospitals, two in Beirut and two in the Bekaa region, were selected. All were privately owned and one in Beirut was a teaching hospital. Sample: All women delivering a live birth in the designated hospitals during a three- to four-month period were recruited into the study. Of the 503 eligible women, 450 agreed to complete the initial questionnaire and 378 completed the postpartum interviews. Methods: Eight trained female interviewers collected the baseline data. On discharge, interviewers handed each woman a sealed and numbered envelope containing the intervention booklet or the placebo leaflets. Interviewers were blind about the allocation group of women. Interviewers conducted follow up assessment at women's residence 6-20 weeks after delivery. Main outcome measures: Any postpartum visit with or without a preset appointment. Results: Multivariable analysis with adjusted ORs show that women given an appointment for their postpartum visit were more likely to having had that visit (OR = 6.8, 95percent CI 6.2-7.4). In the absence of such an appointment, university education (OR = 3.6, 95percent CI 2.6-4.7), information on maternal health (OR = 4.9, 95percent CI 4.0-5.8) and the intervention booklet (OR = 2.9, 95percent CI 2.0-3.9) were important determinants of a postpartum visit. Conclusion: Giving women appointments for postpartum visits, or written or verbal information on maternal health can increase their use of health services. © RCOG 2004.