A Qualitative Study on the Status of Maternal and Infant Health Services in Shanghai Communities under the New Situation

Background With the precipice decline of the birth population and the successive adjustment of the fertility policy in China, it is inevitable to re-examine the breadth and depth of maternal and infant health care services. Also, it has posed great challenges to the community health service institutions, which are the important suppliers of maternal and infant health care services. Objective To investigate the current status of maternal and infant health services in Shanghai communities, in order to provide suggestions and evidence for upgrading the level of primary care services for mothers and infants. Methods From August 2022 to April 2023, using purposive sampling method, the study selected 5 community health centers in the central district of Shanghai, in which in-depth personal interviews were conducted with 10 maternal and infant health service providers during participatory observation; organized a focus group interview with 12 primary health workers in the urban-rural fringe areas. In addition, 8 obstetrics staff from tertiary hospitals participating the construction of obstetrics and gynecology medical consortium, were invited to conduct 2 focus group interviews to obtain information from different perspectives. The data were analyzed using the content analysis method. Results A total of 4 themes and 11 sub-themes were extracted: (1) some health care projects are poorly implemented (inadequate mental health care, ineffective contraceptive guidance, and difficulties in implementation of traditional Chinese medicine health care) ; (2) health talent team construction needs to be strengthened (inadequate human resources, limited professional knowledge and skills, poor motivation to work, and little role of the family physician teams) ; (3) the implementation process is challenging (difficulty in cross-district management and low participation of residents) ; (4) the services integration need to be improved (deviation in the positioning of higher-level medical institutions and insufficient coordination among agencies) . Conclusion At present, maternal and infant health care in Shanghai communities is still facing various challenges. It is necessary to make full use of the opportunity of medical union construction to strengthen talent training and establish an innovative human resource management model. At the same time, when strengthening the top-level design and clarifying the division of tasks between the various tiers of medical institutions, the performance assessment and incentive mechanism should be improved to truly stimulate the morale and service enthusiasm of community maternal and infant health service providers. Multiple measures should be taken to effectively enhance the quality of service and meet the needs of current health care tasks.