Preconception Care Services Research Articles

Determining behavioral intention and its predictors toward preconception care use among reproductive age women in Arba Minch town, Southern Ethiopia, 2022: a cross-sectional study based on the theory of planned behavior

BackgroundPreconception care is a highly effective, evidence-based intervention aimed at promoting the health of reproductive-age women and reducing adverse pregnancy-related outcomes. The Ethiopian Ministry of Health plans to integrate preconception care services into the country’s existing healthcare system. However, women’s preferences may be influenced by their values and customs. Therefore, this study used the theory of planned behavior to assess women’s intention toward preconception care use and its predictors among reproductive-age women in Arba Minch town, southern Ethiopia.MethodsA community-based cross-sectional study was conducted in Arba Minch town from May 1 to 30, 2022. A simple random sampling technique was employed to select 415 study participants for data collection. Data were collected through a face-to-face interview using a pretested, structured questionnaire. Epi Data version 4.6 and SPSS version 26 were used for the entry and analysis of data, respectively. Multiple linear regression was performed to identify independent predictors of intention to use preconception care. The standardized β-coefficient was used as a measure of association. A P value of less than 0.05 was used to declare statistical significance.ResultsThis study had 415 participants, giving a response rate of 98.3%. The mean age of the participants was 28.4 (SD 5.18). The mean intention to use preconception care was 21.43 (SD 2.47). Direct perceived behavioral control (β = 0.263, p < 0.001), direct attitude (β = 0.201, p = 0.001), direct subjective norm (β = 0.158, p = 0.006), and age (β=-0.115, p = 0.023) were significant predictors of women’s behavioral intention to use preconception care.ConclusionThe study identified perceived behavioral control as the strongest predictor, followed by attitude and subjective norms, influencing the intention to use preconception care. These findings underscore the importance of integrating these predictors into health intervention programs aimed at promoting the implementation of preconception care services.

Family Planning and Preconception Care Service Management: The Key Role of Bulgarian GPs.

Assisting women in attaining their reproductive goals is crucial for improving the well-being of families and children. As the first point of contact for healthcare, general practitioners (GPs) are ideal for family planning (FP) and preconception care (PCC). However, primary care interventions' efficacy is unclear. The aim of this study was to examine GPs' knowledge, attitudes, and perspectives on FP and PCC service management. Most GPs were aware of FP and PCC services and held a firm conviction that they should be primarily accountable together with obstetrician-gynaecologists. However, it is worth noting that less than 50% of respondents reported receiving thorough and comprehensive knowledge of their respective specialities. Those with general medicine qualifications demonstrated a high level of commitment to providing such services. The women's GPs and those with training in general medicine prescribed birth control pills and emergency contraception three times more frequently than the other doctors who suggested condoms or traditional methods or referred patients to another specialist (p < 0.05). In conclusion, PCC is of the utmost importance, and its effective implementation demands the collaboration of policymakers, healthcare providers, and individuals. GPs are essential in managing FP and PCC. They must incorporate more in-depth PCC into their clinical practice.

A Scoping Review of Barriers and Facilitators for Preconception Care: Lessons for Global Health Policies and Programs.

Preconception care (PCC) encompasses a set of actions taken before pregnancy to support the health and well-being of women before conception to improve maternal and child health (MCH) outcomes. The utilization of PCC services is influenced by multifaceted factors that can either enable or impede women's capacity to access and utilize them effectively. This scoping review examined the barriers and facilitators influencing the utilization of PCC services among women of reproductive age (15-49 years) at both individual and community levels. Through an extensive review of published articles from 2004 to 2021, including peer-reviewed sources, barriers and facilitators were identified. At the individual level, barriers included limited knowledge about PCC, neglect of self-health, and financial constraints. Community-level barriers encompassed insufficient supply of supplements, restricted access to health care, high health care costs, and setbacks due to delayed delivery of MCH services. Conversely, individuals reported that credible sources of information, such as friends, family, and community health volunteers, facilitated their engagement with PCC services. At the community level, facilitators included government-regulated supply chains for supplements and the involvement of community workers in health monitoring. Understanding and addressing these factors can help improve the utilization of PCC services among women of reproductive age (WRA) and improve MCH outcomes.

Preconception and contraceptive care for women living with HIV/AIDS attending antiretroviral treatment clinics in Lagos State, Nigeria.

Women living with HIV/AIDS possess fertility desires similar to their uninfected counterparts, and with advances in health therapies, these women can realistically have and raise uninfected children. Preconception care (PC) is a specialized form of intervention aimed at the prevention, identification, treatment, and management of biomedical, behavioural, and social conditions that militate against safe motherhood and the delivery of healthy offspring. The study aimed to assess preconception and contraceptive care among women living with HIV and attending Antiretroviral Therapy Clinics in Alimosho, Lagos State, Nigeria. This was a descriptive facility-based cross-sectional study of 383 women of reproductive age living with HIV/AIDS and attending ART clinics in the study area. Probability sampling methods were used in the selection procedures. Data were analyzed using descriptive statistics, Chi-square test, and univariate logistic regression at a 5% level of significance. Stratified and simple random sampling were used in the selection process. Only 37.4% of respondents received optimal PC services. Being 20-29 years old [OR =1.716 (95% CI: 1.664, 1.769), p = 0.020], being 30-39 years [OR =1.514 (95% CI: 0.598, 3.831), p = 0.005], tertiary education [OR =8.43. (95% CI: 1.41, 18.5), p = 0.020], and being single [OR =2.00 (95% CI: 1.928-2.072), p = 0.002] were significantly related to the utilization of contraceptives. There is a need to provide structure and guidelines for optimal streamlined PC and contraceptive services for women living with HIV/AIDS.

Factors influencing the Delivery of Preconception Care Services among Nursing and Midwifery Students at Aga Khan University, Kenya

Preconception care (PCC) is crucial in addressing biomedical conditions, social factors, and risky behaviors that may jeopardize a healthy pregnancy. Despite its significance, nurses, and midwives face challenges in comprehending the importance and components of PCC, hindering their ability to provide comprehensive care. Inconsistencies in training curricula and a lack of in-service training leave students ill-equipped for PCC provision. This study, conducted through a cross-sectional quantitative descriptive approach at Aga Khan University, involved 104 nursing and midwifery students selected through random sampling. The overall knowledge of PCC was 63.35%, 28.8% correctly defined PCC and its components, and while 67.3% of respondents had received PCC training during their previous education 75% had not undergone in-service or refresher training. Moreover, 45% had not provided PCC in the past six months, and only 45.2% of facilities had PCC guidelines, indicating potential standardization gaps. While the study focused on nursing and midwifery students, acknowledging a limitation in representing all healthcare professionals involved in PCC, it emphasized the need to integrate PCC education into curricula. Recognizing PCC as a vital health component underscores its significance, shedding light on gaps in continuing education for healthcare providers. Collaboration among health professionals in delivering PCC services is suggested to enhance care quality. Furthermore, the study advocates for guidelines to standardize PCC services, promoting consistent and high-quality care. Overall, the insights garnered can inform strategies to improve the reproductive and maternal health of women and couples through enhanced PCC services. The health belief model was the theory underpinning the study.

Assessment of the effect of pre-conception care on preventing mother-to-child transmission of HIV in Nyeri County.

the provision of essential preconception care services for HIV-positive pregnant women is crucial to prevent HIV transmission to infants. This includes pregnancy intention screening services, adequate viral load monitoring and suppression before conception, and necessary nutritional support. In Nyeri County, the prevalence of Mother-to-Child Transmission (MTCT) of HIV is 5.3%, which is higher than the global threshold of 5%. This study aims to evaluate the impact of pre-conception care services in preventing HIV transmission to infants in Nyeri County. The study objectives are to assess the utilization of pre-conception care services among HIV-positive women, specifically focusing on pregnancy intention screening, viral load monitoring and suppression, and access to nutritional assessment services before pregnancy. Additionally, the study aims to investigate the relationship between the provision of pre-conception care services and infant HIV outcomes. this cross-sectional retrospective descriptive study employed stratified sampling to select eight level 4 and level 5 hospitals in Nyeri County. The target population consisted of HIV-infected women seeking postnatal care in these facilities, with a sample size of 252 women who had HIV-exposed infants under two years old and were receiving post-natal care at the respective hospitals. Sociodemographic characteristics, including age, marital status, and education level, were collected. Data analysis involved both descriptive and inferential statistics. our findings revealed that only 34.2% of HIV-positive women seeking postnatal care had received information or services related to pregnancy intention screening, a crucial aspect of pre-conception care. Almost half (46.4%) of the women who participated in the study had undergone viral load measurements before pregnancy, which is another critical component of preconception care. Additionally, 85.6% of these women had received nutritional services during pregnancy from their healthcare providers. Interestingly, all women who received any pre-conception care services reported that their infants were alive and tested HIV-negative. preconception care is crucial in preventing mother-to-child transmission of HIV. Efforts should be made to ensure that all HIV-infected women planning to conceive have access to preconception care services.

Screening to understand pregnancy preferences and offer referrals and treatment (SUPPORT): Results of a pilot quality improvement initiative.

To assess the feasibility of integrating a pregnancy intention assessment screening algorithm into the electronic medical record (EMR) at a multispecialty clinic focused on the health of women and people assigned female at birth (AFAB). This pilot quality improvement project implemented a series of clinician reminders, new data fields in the patient record, and templated clinical notes to prompt care providers across specialties to ask AFAB reproductive age individuals about their desire for future pregnancies. Investigators created a novel screening question based on prior literature and expert input. Prospective observational study of one year of during-intervention EMR data on screening uptake and documentation, contraceptive use, and referrals to obstetrics and gynecology (OBGYN) for preconception care, contraceptive care, and related services. SUPPORT launched in February 2020 and was paused for 6 months due to the COVID-19 pandemic. During the intervention period through July 2021, 18% of patients for whom the automated screening reminder was activated had a documented pregnancy intention. Patients were screened in OBGYN, internal medicine, and eight subspecialty medical clinics. Among those screened, individuals who reported they did not desire pregnancy in the next year were more likely to use contraception (aOR 1.8, 95% CI 1.1, 3.1). Individuals that did desire pregnancy in the next year were more likely to be subsequently referred to OBGYN (aOR 2.7, 95% CI 1.2, 6.0). Despite the competing demands of the COVID-19 pandemic, the SUPPORT intervention was utilized at higher rates than prior similar interventions and across multiple disease specialties. Results from the SUPPORT pilot suggest that pregnancy intention screening of reproductive age AFAB individuals with an EMR-based screening prompt is feasible at scale.

Study of pre-conception care (PCC) amongst women in the first trimester coming to the obstetrics and gynaecology (OBGY) outpatient department (OPD) of a hospital in a rural area.

Pre-conception care (PCC) is a set of interventions that aim to identify and modify biomedical, behavioural and social risks to women's health and pregnancy outcomes. It was an observational descriptive cross-sectional study conducted in the obstetrics and gynaecology (OBGY) outpatient department (OPD) of a tertiary care teaching institute in a rural set-up. Two hundred women in the first trimester of pregnancy were interviewed using a pre-designed and pretested questionnaire following informed verbal consent. The study was conducted between May and September 2019. The study excluded women in the 2nd or 3rd trimester of pregnancy, inpatient department (IPD) patients and those unwilling to participate. The study revealed that 25.5% of the women had conceived between 14 and 19 years of age. Fifty-four percent of the pregnancies were unplanned. Merely 14.5% had consulted and 15% had their laboratory investigations performed before pregnancy. Only 11% had received pre-conception folic acid supplementation. Pregnancies with birth spacing <2 years accounted for 15%. The proportion of women with known risk factors was 38% being underweight, 9.5% being overweight, 8% being of short stature (height ≤145 cm), 63% having anaemia (haemoglobin <12 g/dL), 10% with a previous history of abortion, 3.5% with systemic diseases, 4.5% with poor oral hygiene, 1% with domestic violence, 3% with medication, 3% with tobacco addiction and 4.5% with radiation/environmental toxin exposure. One percent had the hepatitis B vaccine and 0.5% had the influenza vaccine. From our study, we conclude that the PCC services are meagre, and unhealthy women who conceive without adequate PCC are prone to maternal and foetal health complications.

Predictors of Preconception Care Reception in a Sample of Iranian Pregnant Women Referred to Qazvin Health Centers

Background: Preconception care (PCC) is one of the most important components of healthcare services for women of reproductive age. Focus on improving preconception health; it can lead to improved reproductive outcomes, healthier pregnancies, and healthier babies. Aim: Determine the predictive factors of receiving PCC in pregnant women of Qazvin. Methods: The present cross-sectional study was conducted from March 2018 to September 2019. Participants were 350 pregnant women in their 6-14 weeks of gestation, who had been referred to a selected comprehensive health center (CHC) for their initial prenatal visits. A two-stage cluster sampling was used to access the samples with maximum socioeconomic and cultural diversity. Data was collected using a questionnaire about demographics, fertility, and factors that affect access to PCC; a questionnaire about perceived social support; and a general self-efficacy questionnaire. Data was analyzed using univariate and multivariate logistic regression methods with SPSS software version 25. Results: In the present study, 57.5% of the participants had received PCC. More than 75% of them received this care less than a year ago at a CHC. In the final model, wanted pregnancy (OR= 11.68), awareness of PCC (OR= 8.86) and history of ART for current pregnancy (OR= 7.18) were the strongest predictors in the model. Conclusion: Women of reproductive age appear to benefit strongly from PCC services, when they have planned their pregnancy and were aware of PCC service. Therefore, information related to the opportunities and potential outcomes of PCC should be made publically available. In addition, healthcare providers should focus more on providing patients with information about preconception counseling.

Socioeconomic Characteristics, Lifestyle Behaviors, and Health Conditions Among Males of Reproductive Age With and Without Disabilities, NHANES 2013-2018.

Health status during the reproductive years influences fecundity, fertility, and the future health of males and their offspring. There remains a dearth of literature examining men's preconception health, especially among high-risk populations, such as those with disabilities. The objective of this study was to examine indicators of preconception health, including chronic medical conditions, lifestyle behaviors, and health care utilization, among males of reproductive age with and without disabilities in the United States. Data were from 3,702 males of reproductive age (18-44 years) who participated in the National Health and Nutrition Examination Surveys, 2013-2018. Approximately 14% of males reported having at least one disability related to vision, hearing, cognition, mobility, self-care, or independent living. Among all men, suboptimal preconception health indicators were prevalent including poor or fair self-rated health; low education and household income status; lack of health insurance and no recent utilization of health care and dental care; cigarette smoking; frequent alcohol consumption and binge drinking; marijuana and illegal drug use; obesity; low fruit and vegetable intake and no multi-vitamin use; low physical activity; short sleep durations; depressive symptoms; and hypertension and asthma. Compared to males with no disabilities, males with any disabilities were more likely to have suboptimal preconception health indicators. Strategies to promote and improve sexual health, preconception care, and family planning services among all men are needed. For males with disabilities, specifically, further investigation of their specific health needs related to sex, reproduction, family planning, and fatherhood, as well as interactions with health care providers, is required.

Perceptions and Beliefs About Preconceptional Care Among Primary Healthcare Workers in Jeddah City, Saudi Arabia: An Analytical Cross-Sectional Study.

Introduction Preconception care (PCC) is one of the important aspects of reproductive health and family planning, from the preventive aspect as primordial prevention forfuture offspring and primary prevention forfemales before pregnancy. However, there is no written protocol about PCC and it is not routinely practiced in Saudi Arabia. This study aimed to assess the perceptions and beliefs among care workers regarding PCC. Methods A cross-sectional study was conducted ongeneral practitioners (GP), family physicians (FP), practitioner nurses (PN), and midwives (MW) in primary healthcare centers (PHC) in Jeddah City using a validated questionnaire that assesses their preconception practices, perceptions, and beliefs. Results This study included 201 participants, of whom 98.5% were Saudi nationals and 80.1% were female. Most (64.7%) were 30-39 years old, followed by 40-49 years old (21.9%). The majority (67.7%) were married and had one or two children (37.3%). Most (36%) were practitioner nurses, followed by family physicians (31%), and had 11-15 years of experience (32%), followed by six to 10 years of experience. The majority (44%) reported providing PCC one to five times last month. Of all participants, 72.63% agreed that PCC affected pregnancy outcomes, and 83% agreed that PCC is important. However, 51.7% agreed there is not enough time to provide PCC services. The service rated as the highest priority was providing advice regarding smoking cessation (82.1%), alcohol cessation (84.6%), control of chronic diseases (85.1%), and information about drug use (86.6%). Most participants rated rubella screening as highly important (89.9%), followed by hepatitis screening (88.6%). Family physicians and practitioner nurses perceived PCC as more important than general practitioners and midwives (p=0.026) and were more likely to perceive hospitals as the optimal setting for PCC (p=0.015). General practitioners were more likely to believe in the insufficient evidence base for PCC (p < 0.001). Conclusion The study found that healthcare workers had good perceptions, knowledge, and attitudes toward the PCC, but their practice was poor. Most lacked formal training and had differing perspectives on PCC, depending on their professions. The findings could inform strategies and measures to improve PCC practice among healthcare workers and raise awareness as well as capacity building by enhancing the training of healthcare workers.

Experiences in the delivery of preconception and pregnancy care for LGBTIQA+ people: A systematic review and thematic synthesis of patient and healthcare provider perspectives

BackgroundThe widespread availability of reproductive technology and family planning services has led to an increase in the number of available pathways to parenthood for LGBTIQA+ people. However, emerging research indicates that significant healthcare inequities have been documented among LGBTIQA+ people and attributed to the pervasiveness of structural and systemic discrimination that extends to preconception and pregnancy care. AimThe aim of this systematic review was to synthesise qualitative research that has explored the experiences of LGBTIQA+ people in navigating preconception and pregnancy care services to inform healthcare quality improvement. MethodSix databases were searched for relevant research published between 2012 and 2023. The findings of all included studies underwent a secondary thematic synthesis, and methodological quality was assessed using the Joanna Briggs Institute Checklist for Qualitative Research. FindingsA total of 37 studies were eligible for inclusion. Four major themes were constructed through thematic synthesis: (1) unavailability of information, services, and support; (2) clinical competencies of healthcare staff; (3) hetero- and cis-sexist care experiences; and (4) discrimination and traumatisation. Conclusions and implications for practiceThe findings of this review indicate that LGBTIQA+ people experience significant challenges during the journey towards parenthood, marked predominantly by the pervasiveness of inequity, and defined by discriminatory healthcare processes. This review has led to several recommendations for future healthcare quality improvement through an investment in policies, procedures, and interactions that are sensitive to the needs of LGBTIQA+ people. Importantly, future research must be co-designed and led by LGBTIQA+ community input.

Preconception health and care policies, strategies and guidelines in the UK and Ireland: a scoping review protocol

IntroductionPreconception care can significantly improve maternal and infant outcomes, and thus optimise intergenerational health. The aims of this scoping review are to (1) provide an up-to-date summary of preconception health...

Feasibility of preconception care services in the Nigerian health system - an exploration of stakeholders' viewpoints

Feasibility of preconception care services in the Nigerian health system - an exploration of stakeholders' viewpoints

Preconception-Health-Related Attitudes of Bulgarian Women of Reproductive Age

Preconception care (PC) is relatively new area of practice. While the volume and quality of PC activities depend on local settings, the awareness of women is critical for the successful promotion of PC services. The aim of this study was to examine the preconception-health-related attitudes and experiences of Bulgarian women of reproductive age. A qualitative study conducted among 20 women aged 18 to 49 years was performed between May and July 2022. Two focus groups were used with mixed samples of nulligravida, pregnant, and postpartum women. The participants thought that the Internet and their obstetrician-gynecologist were the only places where they could learn about getting pregnant. Only two of them discussed their PC plans with their physicians. Women pointed out that general practitioners (GPs) need to be more proactive in promoting PC. All respondents outlined the need for a web-based educational platform that could serve as a primary source of health information for future families. The role and functions of GPs in the continuum of PC should be reconsidered. We recommend targeted educational measures for all stakeholders, including women and GPs. In this regard, an easily accessible, knowledge-based web platform could enhance Bulgarian women's awareness and perceptions of PC.

Assessing the Unmet Preconception Care Needs of Men in the United States by Race/Ethnicity and Nativity

ObjectiveTo estimate the percentage of men in the U.S. in need of preconception care and to assess gaps in utilization of services by race/ethnicity and nativity, irrespective of intention for children, via cross-sectional analysis of 2017–2019 National Survey for Family Growth (NSFG). Methods: The need for preconception care was defined as non-sterile men who had sexual experience and were with female partner(s) who were not sterile. Thirteen preconception care services were assessed across six domains: family planning, blood pressure, HIV, STD, weight management, and smoking cessation. Multivariable weighted analyses were performed to obtain odds ratios to assess differences in preconception care utilization among participants. Results: Approximately 64% of men were estimated to need preconception care. Substantial disparities in need and service use were found across sociodemographic characteristics. Foreign-born men had significantly higher odds of not receiving three of the thirteen preconception care services, including condom use screening (aOR = 1.67; CI = 1.23–2.26), HIV advice (aOR = 1.76; CI = 1.35–2.29), and STD testing (aOR = 1.66; CI = 1.13–2.44), than U.S.-born. Hispanic men had higher odds of not receiving blood pressure (aOR = 1.39; CI = 1.09–1.79) and smoking screenings (aOR = 1.33; CI = 1.02–1.73) than White men. Black men had the highest use in six of the thirteen preconception care services. Conclusion: Gaps in preconception care utilization suggest a need to further explore potential drivers of disparities, specifically for Hispanic and foreign-born men. Additional research into the timing and quality of care received by men are needed to assess the scope, severity, and prevalence of unmet needs within medically underserved communities.

Integration of preconception care into the bachelor of nursing curriculum: An exploratory qualitative study

BackgroundThe significance of ensuring high quality of care has become apparent in nursing and midwifery education worldwide, especially in low- and middle-income countries. This has led to upgrades of the nursing curriculum to include several aspects of care that have been overlooked with recent evidence-based care. ObjectivesTo explore the integration of preconception care (PCC) into the Bachelor of nursing curriculum in South Africa. DesignAn exploratory qualitative study. Setting and participantsThis study was conducted in a higher education institution in South Africa that has recently revised its Bachelor of nursing curriculum. Data sources were Bachelor educators and program documents. MethodsIndividual in-depth interviews were conducted among ten nurse educators. Interviews were complemented with an analysis of the curriculum documents for the Bachelor of nursing program using the BEKA (benchmarking, evidencing, knowing, and applying) model of curriculum analysis and evaluation. FindingsBenchmarking and evidencing of the Bachelor of nursing curriculum reveals a high level of compliance with the externally set standards. Both data sources pointed to some degree of incorporating the preconception care concept into the curriculum. The educators perceived that for full integration to occur, preconception care should be taught as a standalone topic. Lack of focus and poor perception was further reported as barriers to introducing the concept. Most preconception care components and services were taught to students throughout the four hundred levels of the nursing program, especially in the sexual and reproductive health module. Gaps were noted in female genital mutilation, mental health, environmental health, preconception vaccination, and other aspects where preconception care needs emphasis. ConclusionsThere has been a high level of integration of preconception care competency in the Bachelor of nursing curriculum. Especially in the sexual and reproductive health module, most preconception care components are taught to students. However, there is a need to emphasise the preconception nursing management of women with certain conditions. To ensure nurses’ role in providing health for all, safeguarding reproductive health, and maintaining the health continuum is enhanced.

Preconception Care Recommendations, Training, and Competency of Primary Healthcare Nurses in South Africa: A Quantitative Descriptive Study.

There has been a growing interest in preconception care (PCC) as a primary means of tackling the high maternal and child mortality rates, as evidence has shown that the state of maternal health before conception can have a direct impact on the health of the mother and baby. Primary care nurses have been recognized as the highest providers of sexual and reproductive healthcare to the vulnerable population in resource-constrained settings. This study aimed to examine and describe the PCC recommendations, training, and competency of primary healthcare (PHC) nurses in South Africa. A cross-sectional descriptive study was conducted among 196 PHC nurses to examine the PCC recommendations, training, and competency. A self-administered survey tool was used for data collection. The self-reported PCC recommendations, training, and competency of PHC nurses were 63.3%, 88.3%, and 94.9%, respectively, in each aspect. The PCC training among the respondents was mainly in-service training. The only training that was indicated to have been done primarily at a pre-service level was training about reproductive life plan screening and brief counseling. Over 20% of the respondents indicated that they did not receive any training on how to provide alcohol, drug, or tobacco cessation services and how to conduct preconception risk assessments. Although PHC nurses reported a high level of recommendation, training, and competency, their level of reported PCC practice is not equivalent to their provision, as they rendered PCC services to fewer women, and they also reported fewer women seeking PCC. A future longitudinal study is required to examine the reason for low PCC-seeking habits among those at high risk of adverse pregnancy outcomes and contextual factors influencing the provision of PCC services among healthcare workers.

Predictors of preconception health knowledge among Canadian women: A nationwide cross-sectional study.

Optimising preconception health-that is the health of women and men prior to a potential pregnancy-is increasingly recognised as fundamental to improving maternal and infant health outcomes. To date, limited research has been conducted examining preconception knowledge and studies focusing on preconception health behaviours have targeted certain behaviours, while overlooking others, with limited attention given to the interconception period and differences between multiparous and primiparous/nulliparous women. To determine predictors of preconception health knowledge among Canadian women and to examine whether parity modified the effect of predictors on preconception knowledge. A cross-sectional study reported according to STROBE was undertaken from May to June 2019 in Canada with 928 women. An online questionnaire was used including the Preconception Health Knowledge Questionnaire, demographic characteristics, current health status, previous pregnancy outcomes and use of preconception care services. Ordinary least squares regression was used to model knowledge scores. Predictors were entered using theoretically driven hierarchical entry. Mean age of women was 34 years and one in five were immigrants. In the final model, household income (b=.17, SE=.07; p=.009), being born outside Canada (b=-.75, SE=.25; p=.003), miscarriage/stillbirth history (b=.47, SE=.21; p=.027) and previous use of preconception care (b=.97, SE=.20, p ⟩ .001) were predictive of preconception health knowledge. Effect modification by parity was not statistically significant in the final model (f=1.22, p=.19). Women at higher risk of poor preconception knowledge, and who therefore stand to gain from preconception knowledge interventions may include those who (1) are socially and economically disadvantaged; (2) have not engaged in preconception care previously and (3) were not born in Canada. Ensuring national promotion of and access to preconception care is an important strategy to prevent adverse pregnancy outcomes and optimise maternal and infant health. This study highlights the need for national promotion of and access to preconception health care for all pregnancy-planning families in order to improve perinatal outcomes. When evaluating preconception health efforts, preconception health knowledge must be considered within the context of social determinants of health and individuals' abilities to act on their knowledge.

Perception of men's need for preconception care-A qualitative exploration among health care providers and community members.

Several studies have shown that suboptimal health in men can result in poor reproductive health outcomes. The factors associated include lifestyle exposures and poor health-seeking behavior. The poor reproductive health outcomes can be mitigated through preconception care (PCC). PCC services for men are however rare. This qualitative study explored views about men's need for PCC in Nigeria. This exploratory qualitative study was done in Ibadan North Local Government Area, Oyo State, Nigeria. Focus group discussions were held with 12 religious leaders, 22 men and 23 women of reproductive age at the community level. There were key informant interviews with two community leaders and 26 health workers including specialist physicians and nurses at the primary, secondary, and tertiary health care levels. Transcribed data were analyzed thematically using inductive coding on MAXQDA. The reasons participants proffered for men's health requiring attention included men's genetic contribution to pregnancy, treatment of low sperm count, and preventing transmission of infection to their partners. Participants stated however that men are often reluctant about accessing health services until complications arise. Opinions differed on men's need for PCC: while some believed that men need PCC, others expressed contrary views stating that men do not require PCC as the service is more appropriate for women. Successful deployment and uptake of PCC services require the availability of the services and improved awareness about the need to optimize men's health along with that of their partners.