A Study to Evaluate the Efficacy of Different Interventions for Improving Quality of Maternal Health Care Service in China

Background/Introduction: The quality of maternal health care service is a crucial determinant of maternal morbidities and mortalities. This study aimed to explore feasibility and relative efficacy of WeChat (WC), of specialist team (ST) service, and of combined of both interventions (WC-ST) for improving the quality of maternal health care in China. Materials and Methods: A four-arm randomized controlled trial of 1,400 pregnant women was conducted in three hospitals in Chengdu, Southwest China, from December 2016 to October 2017. Eligible women were randomly assigned to either of three intervention groups or the control group (service as usual; SAU). Main outcome measures were satisfaction rate and uptakes of maternal health care service at 49 days postpartum based on questionnaire survey. Results: No significant differences in satisfaction rate were found among four groups at baseline (p = 0.981), and significant group differences were noted at 49 days postpartum (p < 0.001), with the highest rate from WC-ST group (98.6%), followed by that of ST (95.2%) and WC (91.6%) groups, and SAU group being the lowest (85.2%). The same pattern of group difference was observed in measures of health care uptake behaviors. Most health care uptake measures from the baseline to post-trial were significantly improved within each of the intervention groups, while most such measures in the control group were not different from baseline to post-trial. Discussion and Conclusions: The WC and ST service is feasible and potentially effective in improving the quality of maternal health care service in China. The study has revealed limitations and options for improvement in future main trial.