Implementation of Premarital Health Examination (PHE): An Importance-Performance Analysis from Participants who Took PHE in Taiwan

Premarital health examination (PHE) is ideally to prevent sexually-transmitted diseases (STD) within a couple; to detect reproductive problems or hereditary illness which may pass to offspring; and to provide counseling on family planning and genetic health. However, little is known about the implementation of PHE program. We conducted a self- administered questionnaire survey to participants who took PHE in Taoyuan, Taiwan. An importance-performance analysis (IPA) was made to identify which service attributes of PHE program should be improved. Test items and cost of PHE were obtained from the hospitals studied. A total of 336 participants were recruited in 2005. About one-third took PHE after marriage. Only a few PHE programs included screening for reproductive problems (such as semen analysis) or hereditary diseases. Most underwent examinations because of concerns over their own health, reproductive worry, genetic reason and family planning. IPA revealed that the competitive vulnerability (high expectation but low satisfaction) of PHE was unsatisfactory in regard to the examination reports and suggestions regarding genetic health and family planning. Preventing STD transmission within a couple, a function of PHE, is challenged as it is common for couples to have sexual intercourse before marriage and extramarital sexual relationships are common in some places. Without screening for reproductive problems or hereditary illnesses, PHEs are no different from general physical examinations. The couples' desires for information related to reproductive concern, care for their own health, and family planning were not fulfilled. How PHE program implement in Taiwan is recommended.