A controlled evaluation of a health education programme for pregnant women in rural areas.

A controlled evaluation of health education for pregnant women was implemented from 1983 to 1985 in the French north alpine rural area with a quasi-experimental design. Altogether 116 villages (88,983 inhabitants) constituted the pilot zone where the programme took place. This was matched with a control zone of 114 villages (78,800 inhabitants) where routine antenatal surveillance was not changed. The programme involved a large group of health and social workers and institutions and several educational devices. There was a total of 3143 births to the study women during the programme. In all the 45 maternity clinics of the region the mothers were questioned as to their pregnancy history and delivery outcome. The programme succeeded in increasing, in the pilot zone, the proportion of women who benefited from a monthly antenatal visit, whereas no positive trend was shown in the control zones, even when controlling for some identified potential confounders (age and distance to health care providers). Similarly, women in the pilot zone were more likely to attend delivery preparation sessions than women in the control zone. However, many conditions revealed no differential modification in the two study zones. Perinatal morbidity is lower in the north alpine rural area than in the whole country. These results favour further development of social policies for pregnancy and of prenatal care, complemented by better information and training for health and social workers; they also favour better information as to medical monitoring, hygiene, and social rights related to pregnancy.