Needs and feasibility of integrating community children's health care and postpartum contraceptive service

Objective To evaluate the feasibility of providing postpartum contraceptive service at the timing of children's health care visit, so as to provide evidence and recommendation for integrating maternal and child health(MCH) service.

Methods A total of 1 946 postpartum women were recruited for questionnaire survey to analyse their contraception used and needs of receiving postpartum contraceptive services along with children's health care. Meanwhile, in-depth interview and focus group interview were used to collect information regarding strengths and weaknesses of the internal environment, and opportunities and challenge of external conditions for integrating postpartum contraceptive service and children's health care from 26 MCH care providers, managers, and professionals.

Results A total of 1 438 (73.90%) participants resumed their sexual activity. 89.50%(1 287/1 438) used contraception at the first intercourse postpartum. 3.89%(56/1 438) got unintended pregnancy within 2 years postpartum. The proportion of correct use of contraception 12 months after delivery and beyond was below 80.00%. 91.73%(1 785/1 946) expressed their wishes to receive contraceptive information along with children's health care. Most interviewee thought that the integrated MCH service was inevitable for promoting life-course based MCH services. The capacity of community health service and the teamwork of general practitioners were essential elements of integrated MCH services in Shanghai. However, the probability of community health service utilization, shortage of children's health care workforce and unconnected information system between MCH health care might be the barriers for service integration. Maternity security policy implementation and information communication platform establishment would be the opportunities for service integration, but lack of incentive mechanism for MCH care service providers might be challenge for the implementation of service integration.

Conclusion Promoting integration of postpartum contraceptive service and child health care is feasible under the current health resource condition, but practical service model needs to be further explored.