Journal of Womens Health, Issues and Care ISSN: 2325-9795

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Research Article, J Womens Health Issues Care Vol: 4 Issue: 6

Disparity of Public Postpartum Care Services in Japan: A Nationwide Survey of Providers

Fujiko Fukushima1, Tomoko Kodama Kawashima2,3*, Eri Osawa2 and Tomosa Hayashi4
1Faculty of Nursing, Toho University, Japan
2Department of International Health and Collaboration National Institute of Public Health, Japan
3Ann’s Clinic, Midori-no-Kai Medical Cooperation, Japan
4Doctor Course, Graduate school of Medicine, Toho University, Japan
Corresponding author : Tomoko Kodama Kawashima
Department of International Health and Collaboration National Institute of Public Health, 2-3-6 Minami Wako-shi Saitama, Japan, 351-0197
E-mail: [email protected]
Received: November 08, 2015 Accepted: December 01, 2015 Published: December 03, 2015
Citation: Fukushima F , Kawashima TK, Osawa E, Hayashi T (2015) Disparity of Public Postpartum Care Services in Japan: A Nationwide Survey of Providers. J Womens Health, Issues Care 4:6. doi:10.4172/2325-9795.1000214

Abstract

Background: Recent changes in Japanese society, such as a declining birth rate and aging population and the trend towards smaller families have had a serious impact on families with babies and children. It was reported in 2006 that the incidence rate of the onset of major depressive episodes during pregnancy and within 3 months of delivery were 5.6% and 5.0% respectively in Japan. Health centers have played a central role in caring for mothers and babies during the postpartum period since the 1960s. This study aimed to identify current public postpartum care services and the associations between them and local demographic factors. Methods: We conducted a cross-sectional study with multiple regression analysis. Primary data were collected using a semistructured original questionnaire sent by mail to 1,742 health centers in December 2012. Data on demographic factors were acquired from a national open data source. Results: The response rate was 45.1% and the valid response rate was 41.6% (725/1,742). Of the 725 respondents, 60 were Public Health Centers and 665 were Municipal Health Centers. In the multivariate analysis, Public Health Centers had statistically significant higher ORs of carrying out the newborn visit, Hello Baby program or both, a home visit from an expert following referral, and providing help with housework (OR=2.66, 95% CI 1.35–5.24, p=0.005; OR=7.52, 95% CI 2.56–22.10, p<0.001; OR=4.30, 95% CI 2.01–9.17, p<0.001). Conclusions: Home visiting services were the main publiclyfunded postpartum care that was provided, while public facilitybased services, suitable for young couples in economic hardship without any family support, were very limited in Japan. From a multivariate analysis, municipalities with a small population and low Financial Capability Index had more difficulty providing services. A comprehensive approach, including financial support by government, would therefore be required to reduce the disparity in public postpartum care services.

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