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

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, 95% CI 6.2-7.4). In the absence of such an appointment, university education (OR = 3.6, 95% CI 2.6-4.7), information on maternal health (OR = 4.9, 95% CI 4.0-5.8) and the intervention booklet (OR = 2.9, 95% 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.