Proportion Of Postpartum Women Research Articles

Effect of Interventions in Improving Awareness, Knowledge and Practices of PPFP among Women and Health-Care Providers in Bihar; a Pre- and Post-Intervention Study

Background: Post-partum family planning (PPFP) within first 12 months of childbirth is known to improve maternal and neonatal health outcomes. This study evaluates the effect a package of PPFP interventions in improving level of awareness, knowledge and practices of post-partum women.
 Methods: A before and after intervention cross sectional study was conducted in 18 public health facilities and their catchment areas across 5 districts of Bihar. Participants included randomly selected postpartum women and purposively selected health service providers. A standard questionnaire was used to assess the level of knowledge, awareness and practices related to post-partum family planning before and after the intervention.
 Results: A total of 972postpartum women,27 doctors, 46 nurses, 89 Auxiliary Nurse Midwives (ANM) and 89 Accredited Social Health Activists (ASHA) as well as 981 postpartum women, 18 doctors, 53 nurses, 90 ANMs and 90 ASHAs were interviewed during baseline and end line respectively. This intervention package increased knowledge regarding postpartumreturn to fertility, modern FP methods and criteria of lactational amenorrhoea method. Also, the proportion of post-partum women who reported receiving FP counselling were increased.
 Conclusion: The findings of this study demonstrate that effective implementation of a package of PPFP interventions at a scale can lead to improvement in the knowledge and awareness levels of both health workers and post-partum women.

Prevalence of Positive Mental Health and Associated Factors Among Postpartum Women in Canada: Findings from a National Cross-Sectional Survey

ObjectivesThe objectives of this study were to compare the prevalence of three positive mental health (PMH) outcomes (self-rated mental health, life satisfaction, sense of community belonging) in postpartum women to the general population, and to examine the relationship between protective factors and the three PMH outcomes among postpartum women.MethodsThe national cross-sectional Survey on Maternal Health (n = 6558) was analyzed. Analyses were weighted and 95% confidence intervals were calculated. Three adjusted logistic regression models were generated. To compare this sample to the general population of women, estimates from the Canadian Community Health Survey—Annual Component (2018) were used.ResultsCompared to the general population of women, a larger proportion of postpartum women reported a strong sense of community belonging. The odds of postpartum women with high self-rated physical health having high self-rated mental health were approximately seven times greater (aOR 6.9, 95% confidence interval [CI] 5.9, 8.1) than postpartum women with lower self-rated physical health. The absence of symptoms of postpartum depression (PPD) or generalized anxiety disorder (GAD) and high self-rated physical health were significantly associated with all three PMH outcomes. Frequent availability of maternal support was associated with greater odds of high life satisfaction (aOR 1.6, 95% CI 1.4, 1.9) and sense of community belonging (aOR 1.4, 95% CI 1.2, 1.6).ConclusionsOur study demonstrated that availability of maternal support, self-rated physical health and absence of symptoms of PPD or GAD were associated with PMH among postpartum women. As physical health had the strongest association with mental health, we encourage further examination of this relationship.

Clan-involved approaches to increasing antenatal care use in a rural minority area of China: implementation research.

This study aimed to test a model which involved clans and health providers to increase antenatal care attendance in rural minority areas of China with high HIV prevalence. Formative research was conducted to determine barriers and facilitators to antenatal care use. A strategy involving clans in addressing the barriers identified was developed. Implementation of the new strategy was done through three plan-do-study-act (PDSA) cycles, lasting four months each. Awareness and uptake of antenatal care increased significantly after the intervention. The proportion of post-partum women who used any antenatal care increased from 21.3% to 64.5% (p<0.001), and the proportion who knew that antenatal care is necessary increased from 77.8% to 89.8% (p<0.001). The proportion of pregnant women who attended antenatal care (p<0.001) and the proportion of pregnant women who went for a first antenatal care visit in early pregnancy (p<0.001) all showed increasing trends during the study period. Involving clans in antenatal care programmes in rural minority areas of China had an impact on antenatal care use. A quality improvement approach incorporating PDSA cycles can help local health authorities make context-specific, evidence-informed decisions to improve uptake of health services.

Integrating family planning into postpartum care through modern quality improvement: experience from Afghanistan.

To address low contraceptive use in Afghanistan, we supported 2 large public maternity hospitals and 3 private hospitals in Kabul to use modern quality improvement (QI) methods to integrate family planning into postpartum care. In 2012, QI teams comprising hospital staff applied root cause analysis to identify barriers to integrated postpartum family planning (PPFP) services and to develop solutions for how to integrate services. Changes made to service provision to address identified barriers included creating a private counseling space near the postpartum ward, providing PPFP counseling training and job aids to staff, and involving husbands and mothers-in-law in counseling in person or via mobile phones. After 10 months, the proportion of postpartum women who received family planning counseling before discharge in the 5 hospitals increased from 36% to 55%, and the proportion of women who received family planning counseling with their husbands rose from 18% to 90%. In addition, the proportion of postpartum women who agreed to use family planning and left the hospital with their preferred method increased from 12% to 95%. Follow-up telephone surveys with a random sample of women who had received PPFP services in the 2 public hospitals and a control group of postpartum women who had received routine hospital services found significant differences in the proportion of women with self-reported pregnancies: 3% vs. 15%, respectively, 6 months after discharge; 6% vs. 22% at 12 months; and 14% vs. 35% at 18 months (P < .001). Applying QI methods helped providers recognize and overcome barriers to integration of family planning and postpartum services by testing changes they deemed feasible.