Factors influencing the quality of preconception healthcare in China: applying a preconceptional instrument to assess healthcare needs

Abstract

BackgroundPreconception care is defined as the promotion of the health and well-being of a woman and her partner before pregnancy. Improving preconception health can result in improved reproductive health outcomes. China has issued latest version official guideline for preconception care in 2011. The objective of this cross-sectional study is to determine whether there is a variation in the quality of preconception healthcare services in distinct eastern and northern populations of China, and what factors are associated with such variation.MethodsA cross-sectional survey using our previously developed preconception instrument was conducted. Women at reproductive age planning for pregnancy were surveyed along with their partners at hospitals during their pre-pregnancy health examination. Data collected include general health/life profiles, pregnancy history, alcohol/tobacco/drug exposures, immunizations, micronutrient supplements and the demands in preconception care. After quality assessment, statistical analysis were applied to evaluate the variations in preconception factors between people from Hebei and Jiangsu Provinces.Results3202 women of reproductive age in from eastern province, Jiangsu, and in a northern province, Hebei, participated this study. 2806 of them and their partners have completed the questionnaire, at a rate of 87.6%, 1011 were from Jiangsu and 1795 were from Hebei. Statistical significance was obtained for maternal age (P < 0.001), body mass index (u =13.590, P <0.001), education (χ2 = 916.33, P < 0.001), occupation (χ2 = 901.78, P < 0.001), health status/common disease, immunization status, and need for preconception care.ConclusionsFor a country as large as China, the centralized guideline for standardized preconception healthcare does have a very crucial positive role in reproductive healthcare, but it may not be suited for all populations. Regional authorities should consider the demographics and healthcare needs of the local population and modify the centralized guideline accordingly, as well as provide a better education and professional services for the public, to improve the quality of preconception services at both the regional and the national level.

Atención preconcepcional: brechas en la atención de la salud sexual y reproductiva El Salvador

“…En 2006, los Centros para el Control y la Prevención de Enfermedades de Atlanta, en Estados Unidos (CDC, por sus siglas en inglés) publicaron recomendaciones para mejorar la salud preconcepcional y el cuidado médico 8 . Después, Países Bajos y Canadá han emitido sus propias recomendaciones nacionales para la atención preconcepcional 9 . La OMS, en 2012, presentó el "Plan de acción para acelerar la reducción de la mortalidad materna y mortalidad materna grave", proponiéndose como una medida concreta la organización de los servicios de salud para la atención de la mujer antes del embarazo, continuando con atención del embarazo, parto y puerperio, con el fin de reducir dicha mortalidad 10,11 .…”

“…De acuerdo con la bibliografía revisada [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] , la conceptualización de la atención preconcepcional debe cumplir varias características: darse antes de la concepción con un mínimo de 6 meses, tener seguimiento de acuerdo con la situación de la mujer y la pareja, promocionar la salud antes del embarazo, prevenir riesgos para la madre y el futuro bebé. Lo www.alerta.salud.gob.sv…”

“…En El Salvador, se ha explorado el conocimiento de los factores de riesgo para el embarazo en población en edad fértil, no así la promoción de atención preconcepcional, ni la demanda de dicho servicio por las usuarias y su pareja [20][21][22][23] . Por tanto, no se describe ningún dato epidemiológico nacional de dicha atención desde la implementación del lineamiento que visualice la atención preconcepcional y la búsqueda de los riesgos reproductivos en poblaciones dentro de territorios de atención de algunas unidades comunitarias de salud familiar, al igual que los estudios internacionales revisados [8][9][10][11][12][13][14][15][16][17]19 .…”

Abordagem de necessidades de saúde pelo enfermeiro na consulta pré-natal / Approaching health needs by nurse in prenatal consultation

“…The conclusion was obtained from the identification of the health needs of couples in gestational planning in the provinces of Hebei and Jiangsu in China, selected for their marked environmental, geographic and economic differences. 10 In this direction, considering the singularities of each population group, international studies also highlight the needs of specific groups of pregnant women, such as adolescent mothers. A study of their needs, carried out in an educational context in Costa Rica, identified each family as the main source of support for adolescents.…”

A new perspective on universal preconception care in China

“…Therefore, expansion of the NFPHEP to urbanized China will require significant efforts. Some modifications in the guidelines may also be required depending on local population demographics . Second, this totally free preconception healthcare model is unique in the world, but whether this will be sustainable remains to be seen.…”