Abstract
BackgroundPreconception care has the potential to reduce maternal and child morbidities and mortalities. It is a window of opportunity to timely alter or eliminate risk factors for adverse pregnancy outcomes. However, despite strong evidence on the effectiveness of preconception care in safeguarding maternal and child health, its uptake remains low. Therefore, this study aimed to explore barriers to the uptake of preconception care.MethodsA descriptive qualitative study was conducted in Mana district, Jimma Zone, Oromia region, Southwest Ethiopia from March 02 to April 10, 2019. A purposive sampling approach was used, and 13 key informant interviews (6 in rural and 7 in urban areas) were held with women of different age groups, health extension workers, and health care providers of different professions. In addition, 4 focused group discussions with women of reproductive age groups (two with rural women only and two with urban women only) were conducted. The data were collected by trained experts using semi-structured guides. An inductive process of thematic analysis was employed and the data were coded, categorized, and thematized using Atlas ti version 7.0.71 software.ResultsFour women of reproductive age groups, 1 older woman (grandmother), 2 health extension workers, and 6 health care providers of different professions were interviewed. In addition, a total of 38 women of reproductive age groups participated in the 4 focused group discussions: 20 in the two rural-focused group discussions and 18 in the two urban-focused group discussions. The findings indicated the presence of many barriers affecting the uptake of preconception care and organized into five themes: women-related barriers, husband-related barriers, community-related barriers, health-service-related barriers, and media-related barriers.ConclusionsThis study found a diverse array of potentially modifiable barriers to the uptake of preconception care. The findings imply the importance of scaling up health education and counseling, establishing preconception care strategies and functional units that can address all the components at all levels of health care facilities. Therefore, we recommend all stakeholders, such as program planners and managers, non-governmental organizations, media personnel, and health care providers to work in collaboration to increase the uptake of preconception care.
Highlights
Preconception care has the potential to reduce maternal and child morbidities and mortalities
This study found a diverse array of potentially modifiable barriers to the uptake of preconception care
We recommend all stakeholders, such as program planners and managers, non-governmental organizations, media personnel, and health care providers to work in collaboration to increase the uptake of preconception care
Summary
Preconception care has the potential to reduce maternal and child morbidities and mortalities. Preconception care (PC) is a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to women’s health or pregnancy outcomes through prevention and management [1]. Maternal mortality and morbidity are still major health problems [7], especially in low- and middleincome countries where 99% of all maternal and newborn deaths occur [8]. This can be due to a clear gap in the continuum of care, for women who are not pregnant. Ethiopia is highly suffering from maternal and child mortalities, where the maternal mortality rate was 412 deaths per 100,000 live births [9], under-five mortality rate 55 deaths per 1000 live
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