The development and evaluation of a health education programme for pregnant women in a regional hospital, southern Thailand

The maternal mortality rate (MMR) in Thailand is higher than neighbouring d eveloping countries including Malaysia and Singapore. The 1993 MMR of Thail and was 249 per 100 000 livebirths which was four times higher than the rat es in Malaysia and Singapore (World Health Organization 1995). The major ca uses of these deaths were haemorrhage, toxaemia of pregnancy and sepsis whi ch were likely to be prevented by adequate prenatal care (Thailand Ministry of Public Health 1996). A large proportion of Thai pregnant women have poo r health. Between 1994 and 1995, a national study conducted by Thailand Min istry of Health showed that 39% of pregnant women were anaemic, defined as haemoglobin concentration lower than 33% (Supamethaporn 1997). Another stud y conducted in the southern region also indicated that 13.8% of pregnant wo men were anaemic caused by iron deficiency (Phatthanapreechakul et al. 1997 ). Other behaviours which increased risks associated with child birth inclu ded non-antenatal care (ANC) attendance, undertaking physically demanding t asks and failure to increase nutritional intake during their pregnancy peri od (N. Phiriyanuphong et al. 1992, unpublished report). These factors empha size the importance of a health education programme which could facilitate women to, for example, increase protein and iron intake during pregnancy wh ich would reduce complications from their poor health status. This study wa s conducted in a regional hospital in Thailand where there was no systemati c and well-planned health education programme for pregnant women. The initi al aim was to design a health education programme using input from the hosp ital health care professionals including obstetricians, nurses, nutritionis ts, health educators and health promoters. An active involvement of these p ersonnel assisted to sustain the provision of the programme provided for pr egnant women after the cessation of the study project. Another aim of the s tudy was to evaluate the outcomes of the programme using a pre-test-post-te st method among selected pregnant women who participated in the newly desig ned health education programme.