Social Marketing Preconception Care: a Pilot Study

1
Social Marketing Pre-conception Carea Pilot
Study

• Li Zhu, MD, MPH
• National Center for Maternal and Infant Health
• Peking University Health Science Center
• 21 June 2005, Atlanta, GA

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Outline

• Goals
• Objectives
• Approaches
• Conclusions

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Goals of the pilot project

• To improve pre-conceptional health rate
• Long-term goals
• Most (80) women seek health care before
  conception in the coming 5 years
• Short-term goals
• 30 women seek health care before pregnancy
  one year after implementing the project.

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Objectives of the pilot project

• Test and refine a pre-conceptional health care
  social marketing plan
• To introduce a new concept of pre-conception care
  
• To let target subjects realize the importance of
  pre-conception care
• To encourage women to seek pre-conception care
  voluntarily

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Steps of the pilot project

• 1. Baseline market research
• 2. Implementation plan
• 3. Testing the plan
• 4. Refining the plan

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Market research

• Time, location, and subjects
• Approaches
• Existing problems

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Time, location and subjects

• Time Feb 2004 Mar 2005
• Location
• Xianghe County, Langfang City, Hebei Province
• Mancheng County, Baoding City, Hebei Province
• Huishan District, Wuxi City, Jiangsu Province
• SubjectsWomen of childbearing age
• MCH workers
• Local officials

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Approaches of the market research

• Questionnaire
• 7 different sets
• Sent 10,177
• Received 9,314
• Interview
• 11 different sets of interview outline
• 57 interview sessions
• 140 subjects interviewed

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Problems identified from the market research

• Target subjects
• Couples planning marriage misunderstanding
  voluntary is perceived to mean as ususal or
  unnecessary. After the implement of the new
  Marriage Registry Ordinance (Oct 2003), the
  number of women who received pre-marital exams
  dropped dramatically
• Health care organizations
• Pre-conception care services are not
  systematically organized
• Government
• The relevant departments are not working
  collaboratively
• Media

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Implementation plan of the pilot project

• 1. To use the concept and methods of social
  marketing to solicit support from the government,
  and
• 2. To coordinate relevant departments or
  organizations properly
• 3. To coordinate with the relevant departments of
  the government, and to intensify management
• 4. To market the concept of pre-conceptional
  health care, and to motivate the potential target
  subjects
• 5. To train MCH workers at all levels to
  implement the plan

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Field testing

• To test ways to seek government support, and to
  test organization of the pre-conception care
• To test the participation and involvement of
  relevant government departments
• To test the communicational methods, contents,
  and media

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Soliciting government support

• Orientation with the relevant officials via
  interviews, talks etc.
• To hold workshops at county level to create
  favorable environments for pre-conceptional care
• To setup the project coordination committee and
  implementing team
• The county government issues the red-headed
  document On Implementing Pre-conception Care
  Social Marketing Pilot projects to officially
  launch the pilot

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Organizational chart of the pilot study
Coordination committee
Vice Mayor
Bureau of Health Director
Bureau of Family Planning Director
Chairman of the Womens Federation
County Women Office Vice director
Bureau of Civil Administration Director
County Project office Vice Director
---
Implementing team
County Health Bureau
MCH director
Vice director
MCH section Head
Health care department Chief physician
Office of director
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The launch of the pilot project

• Presided by the deputy county Mayor
• Director of the department of health presented
  the implementation plan
• Professor Li Zhu and Dr. Gindler gave talks on
  the importance of this pilot project
• Deputy county Mayor gave a talk on the importance
  of the project implementation
• Attendees including members of the project
  coordination committee and the project
  implementation team, township officials, and
  leaders of health care organizations

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Lessons learned from social marketing launch

• The meeting was presided by the leading officials
  of the county government, which indicates the
  importance of the project
• Lectures presented by the experts, which implies
  the project has scientific merit
• Leading officials of the county government
  emphasized the importance of this project, which,
  in turn, can improve the coordination and
  involvement of governmental departments

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Coordination among governmental departments or
organizations

• 1. MCH institute works with the Marriage
  Registration Office of the Department of Civil
  Affairs to conduct consultation, education and
  other works relevant to pre-conception care
  services      
• 2. Communicating with the Department of Civil
  Affairs and the Family Planning Commission for
  conducting education with people registering and
  planning to have a baby
• 3. Workshops on preconception care during the
  village and county level meetings of the Womens
  Federation have been planned

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Exploring the best communication method, contents
and media

• Conclusion from Family questionnaire interview
• Most suitable communicational materials are
  handouts, VCDs and slogans
• Women prefer information that includes knowledge
  of prenatal health care and methods of birth
  defect prevention
• Better services regarding consultation and
  examination are needed
• Family visits and face-to-face communication on
  the importance of birth defects prevention and
  importance of preconception care recommended

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• Conclusions resulted from workshops in Mancheng
  County
• Our communication method is welcomed by the
  public
• The best way to motivate the public is education
  and communication slogans and cases studies
• Quiz is a good way to motivate the public
• 100 awareness of the importance of preconception
  care can be achieved
• After the workshop, 95.45 subjects reported
  willing to pay 100 RMB or more to receive
  preconception care services
• 50 of the public wanted to get more and better
  MCH knowledge and consultation

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Candidate health education messages
1) Pre-conception care is the starting point for
getting a healthy baby! 2) Pre-conceptional
health care guarantees you to be a happy mommy!
3) Want a healthy baby? Please receive the
pre-conception care services! 4) Better
pre-conception care, fewer family worries! 5)
Receive pre-conception care to prevent birth
defects!
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Improvement of the plan

• Establish effective communication and training
  network responsibilities of the project office
• 1) Designing the materials targeted to different
  subjects
• 2) Training of all the cooperation committee and
  project implement team
• 3) Holding training courses through project
  office and the three level health care system for
  maternal and infant health
• 4) To train 4-5 professionals as communication
  leaders in one project county
• 5) Encourage village directors of the Women
  Federation to disseminate information on
  preconceptional health care

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• Improve the quality of the entire health care
  service organizations
• 1) To emphasize the service nature MCH institutes
  in order to meet the increasing needs for health
  care services of the society
• 2) To hold specialized workshops to improve the
  quality and technique of prenatal health care
  services
• 3) To improve the promotional mechanism to better
  motivate MCH workers
• 4) To update the equipment of our MCH
  organizations and to improve the working
  environment.

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Conclusions of the pilot project county

• 1. It is possible for the government to
  understand and support the preconception care
  project
• 2. All the relevant parties can work together
• 3. The target subjects are willing to accept the
  concept of preconception care
• 4. Village face-to-face communication is the most
  substantial way to educate and motivate the
  target subjects
• 5. The preferred information of the public is
  that related to the knowledge of preconception
  care and the methods of birth defects prevention

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Conclusions of the pilot project
county(continued)
6. The most effective tools include posters,
handouts, VCDs, slogans etc. 7. Slogans and case
studies can best motivate the public 8. The
public need more professional consultation and
health assessment services 9. Currently, the
well-known slogan is Better pre-conceptional
health care, fewer family worries! 10. The
ultimate goals can only be achieved by continuous
improvement of the implementation plan