Abstract
BackgroundIn high-income countries, great disparities exist in the organizational characteristics of maternity health services. In Finland, primary maternity care is provided at communal maternity health clinics (MHC). At these MHCs there are public health nurses and general practitioners providing care. The structure of services in MHCs varies largely. MHCs are maintained independently or merged with other primary health care sectors. A widely used organizational model of services is a combined maternity and child health clinic (MHC & CHC) where the same public health nurse takes care of the family from pregnancy until the child is at school age. The aim of this study was to determine how organizational model, MHC independent or combined MHC & CHC, influence on women’s and their partners’ service experiences.MethodsA comparative, cross-sectional service evaluation survey was used. Women (N = 995) and their partners (N = 789) were recruited from the MHCs in the area of Turku University Hospital. Four months postpartum, the participants were asked to evaluate the content and amount of the MHC services via a postal questionnaire. Comparisons were made between the clients of the separate MHCs and the MHCs combined to the child health clinics.ResultsWomen who had used the combined MHC & CHCs generally evaluated services more positively than women who had used the separate MHCs. MHC’s model was related to several aspects of the service which were evaluated “good” (the content of the service) or “much” (the amount of the service). Significant differences accumulated favoring the combined MHC & CHCs’ model. Twelve aspects of the service were ranked more often as “good” or “much” by the parents who had used the combined MHC & CHC, only group activities regarding delivery were evaluated better by women who had used the separate MHCs.ConclusionsBased on the women’s and partners’ experiences an organizational model of the combined MHC & CHC where the same nurse will take care of family during pregnancy and after birth of the child was preferred. This model also provides greater amount of home visits and peer support than the separate MHC.
Highlights
In high-income countries, great disparities exist in the organizational characteristics of maternity health services
In Finland, primary maternity care is provided by public maternity and child health clinics [9] that were mandated by law in 1944 to guarantee free health care services for every pregnant woman and all children under school age
The majority of the participants used the services of the separate maternity health clinics (MHC) (N = 740, 76.4%) and nearly a quarter (N = 228, 23.6%) the combined MHC & Combined maternity and child health clinic (CHC)
Summary
In high-income countries, great disparities exist in the organizational characteristics of maternity health services. The organizational framework of maternity care services varies greatly in European countries Despite this disparity, many positive aspects - in terms of maternal and infant health - could be reached [1]. Many positive aspects - in terms of maternal and infant health - could be reached [1] This observation is confirmed by several studies evaluating the relationship between the organizational features of the maternity care services, such as professional education of the main care provider [2,3], number of visits [4,5] or model of the care [6,7,8], and pregnancy or infant outcomes. From 1972, due to the Public Health Act, MHC services were carried out as part of the newly established municipal health center and were usually led by the public health nurses (PHNs) with general practitioners (GPs)
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