Cluster Sampling with Referral to Improve the Efficiency of Estimating Unmet Needs among Pregnant and Postpartum Women after Disasters

Abstract Introduction and Background Women of reproductive age, in particular women who are pregnant or fewer than 6 months postpartum, are uniquely vulnerable to the effects of natural disasters, which may create stressors for caregivers, limit access to prenatal/postpartum care, or interrupt contr...

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Bibliographic Details
Published in:Women's health issues 2012-05, Vol.22 (3), p.e253-e257
Main Authors: Horney, Jennifer, PhD, MPH, CPH, Zotti, Marianne E., DrPH, MS, FAAN, Williams, Amy, MPH, Hsia, Jason, PhD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Cluster Analysis
Disasters
Female
Floods
Georgia
Health Services Needs and Demand
Humans
Infant, Newborn
Male
Maternal Health Services - organization & administration
Maternal Welfare
Middle Aged
North Carolina
Obstetrics and Gynecology
Pilot Projects
Population Surveillance - methods
Postpartum Period
Postpartum women
Pregnancy
Referral and Consultation
Referrals
Sampling
Sampling Studies
Surveys and Questionnaires
Unmet needs
Women
Young Adult
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Summary:Abstract Introduction and Background Women of reproductive age, in particular women who are pregnant or fewer than 6 months postpartum, are uniquely vulnerable to the effects of natural disasters, which may create stressors for caregivers, limit access to prenatal/postpartum care, or interrupt contraception. Traditional approaches (e.g., newborn records, community surveys) to survey women of reproductive age about unmet needs may not be practical after disasters. Finding pregnant or postpartum women is especially challenging because fewer than 5% of women of reproductive age are pregnant or postpartum at any time. Methods From 2009 to 2011, we conducted three pilots of a sampling strategy that aimed to increase the proportion of pregnant and postpartum women of reproductive age who were included in postdisaster reproductive health assessments in Johnston County, North Carolina, after tornadoes, Cobb/Douglas Counties, Georgia, after flooding, and Bertie County, North Carolina, after hurricane-related flooding. Results Using this method, the percentage of pregnant and postpartum women interviewed in each pilot increased from 0.06% to 21%, 8% to 19%, and 9% to 17%, respectively. Conclusion and Discussion Two-stage cluster sampling with referral can be used to increase the proportion of pregnant and postpartum women included in a postdisaster assessment. This strategy may be a promising way to assess unmet needs of pregnant and postpartum women in disaster-affected communities.
ISSN:1049-3867
1878-4321
DOI:10.1016/j.whi.2012.01.002