A cross-sectional analytic study of postpartum health care service utilization in the Philippines.
BACKGROUND
The maternal mortality ratio in the Philippines remains high; thus, it will be difficult to achieve the Millennium Development Goals 5 by 2015. Approximately two-thirds of all maternal deaths occur during the postpartum period. Therefore, we conducted the present study to examine the current state of postpartum health care service utilization in the Philippines, and identify challenges to accessing postpartum care.


METHODS
A questionnaire and knowledge test were distributed to postpartum women in the Philippines. The questionnaire collected demographical characteristics and information about their utilization of health care services during pregnancy and the postpartum period. The knowledge test consisted of 11 questions regarding 6 topics related to possible physical and mental symptoms after delivery. Sixty-four questionnaires and knowledge tests were analyzed.


RESULTS
The mean time of first postpartum health care visit was 5.1 ± 5.2 days after delivery. Postpartum utilization of health care services was significantly correlated with delivery location (P<0.01). Women who delivered at home had a lower rate of postpartum health care service utilization than women who delivered at medical facilities. The majority of participants scored low on the knowledge test.


CONCLUSIONS
We found inadequate postpartum health care service utilization, especially for women who delivered at home. Our results also suggest that postpartum women lack knowledge about postpartum health concerns. In the Philippines, Barangay health workers may play a role in educating postpartum women regarding health care service utilization to improve their knowledge of possible concerns and their overall utilization of health care services.
Kobe City College of Nursing, Nursing, Kobe, Japan ; Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.
Tadashi
T
Yamashita
Department of Obstetrics and Gynecology of the Philippine General Hospital, Manila, Philippines.
Sherri Ann
SA
Suplido
Department of Obstetrics and Gynecology of the Philippine General Hospital, Manila, Philippines ; University of the Philippines, College of Medicine, Manila, Philippines.
Cecilia
C
Ladines-Llave
Department of Nursing, Seisen University, Hikone, Japan.
Yuko
Y
Tanaka
Department of Maternity Nursing, Kobe University Graduate School of Health Sciences, Kobe, Japan.
Naomi
N
Senba
Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.
Hiroya
H
Matsuo
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008428:Maternal Mortality; D010342:Patient Acceptance of Health Care; D010679:Philippines; D049590:Postpartum Period; D011247:Pregnancy; D011795:Surveys and Questionnaires