Grant: Partnerships for Health System Improvement (PHSI)

Prenatal care has the potential to improve the health of pregnant women and reduce the incidence of poor infant outcomes, and is more likely to be effective if women begin receiving care in the first trimester of pregnancy and continue to receive care throughout pregnancy. Despite the emphasis placed on the value of prenatal care, some pregnant women continue to receive inadequate prenatal care. Previous research has shown wide regional variations in use of prenatal care in Manitoba, with a geographic concentration of high rates of inadequate prenatal in northern areas of the province and in the inner-city areas of Winnipeg. These inequities in use of prenatal care emphasize the need for effective targeted services and programs. The purpose of this study is to assess the effectiveness of three "health system improvement" initiatives aimed at improving access to and use of prenatal care by inner-city women, including: (1) incorporating midwifery care at existing Healthy Baby community support groups; (2) expanding existing mobile van services to offer prenatal care and link women to the appropriate health care providers; and (3) implementing a social marketing campaign (e.g., brochures, posters, Facebook/Twitter, text messaging) to promote the importance of prenatal care and provide information on where women can receive prenatal care. This study will evaluate the rates of inadequate prenatal care before and after the initiatives are implemented, as well as women's and health care providers' experiences with receiving and providing prenatal care within these initiatives.