Determinants of practice of preconception care among women of reproductive age group in southern Ethiopia, 2020: content analysis

Abstract

Background Preconception care (PCC) is a series of biomedical, mental, and psycho-social health services provided to women and a couple before pregnancy and throughout subsequent pregnancies for desired outcomes. Millions of women and new-borns have died in low-income countries due to impediments that arise before and exaggerate during pregnancies that are not deal with as part of pre-conception care. To the best of our knowledge, however, there is a lack of information about preconception care practice and its determinants in southern Ethiopia, including the study area. This study was therefore planned to assess the practice of preconception care and its determinants among mothers who recently gave birth in Wolkite town, southern Ethiopia, in 2020. Methods A community-based cross-sectional study was conducted from February 1 to 30, 2020. A total of 600 mothers who have given birth in the last 12 months have been randomly selected. A two-stage sampling technique was employed. For data collection, a pre-tested, semi-structured questionnaire was used. The data was encoded and entered into Epi-Data version 3.1 and exported for analysis to SPSS version 23. Household wealth status was determined through the application of principal component analysis(PCA). The practice PCC was considered as a count variable and measured as a minimum score of 0 and a maximum of 10. A bivariable statistical analysis was performed through analysis of variance (ANOVA) and independent t-tests and variables with a p-value of < 0.05 were eligible for the generalized linear regression model. To see the weight of each explanatory variable on PCC utilization, generalized linear regression with a Poisson link was done. Results Of the sampled 600 participants, 591 took part in the study, which yielded a response rate of 98.8%.The mean (± SD) score of the practice of PCC was 3.94 (± 1.98) with minimum and maximum scores of 0 and 10 respectively. Only 6.4% (95%CI: 4.6, 8.6) of mothers received all selected items of PCC services. Thecommonest item received by 67.2% of mothers was Folic acid supplementation, while 16.1% of mothers received the least item of optimizing psychological health. Education status of mother[AOR 0.74, 95%CI 0.63, 0.97], time spent to access nearby health facilities [AOR 0.69, 95%CI 0.58, 0.83], availability of PCC unit [AOR 1.46; 95%CI 1.17, 1.67], mother’s knowledge on PCC [AOR 1.34, 95%CI 1.13, 1.65], being a model household [AOR 1.31, 95%CI 1.18, 1.52] and women’s autonomy in decision making [AOR 0.75, 95%CI 0.64, 0.96] were identified as significant predictors of practice of PCC. Conclusion The uptake of WHO-recommended PCC service elements in the current study area was found to be unsatisfactory. Stakeholders must therefore increase their efforts to align PCC units with existing MNCH service delivery points, improve women's decision-making autonomy, and focus on behavioral change communication to strengthen PCC practice. Plain language summary Preconception care (PCC) is a series of biomedical, mental, and psycho-social health services provided to women and a couple before pregnancy and throughout subsequent pregnancies for better endings. The main goal of the PCC is to improve maternal and child health outcomes, by-promoting wellness and providing preventive care. It can also be seen as an earlier chance for teenage girls, mothers, and children to live a better and longer-term healthy life. Pieces of PCC service packages suggested by the World Health Organization(WHO) are, micronutrient supplementation (Folate supplementation), infectious disease (STI/HIV) screening and testing, chronic disease screening and management, healthy diet therapy, vaccination, prevention of substance use (cessation of cigarette smoking and too much alcohol consumption), optimizing psychological health, counseling on the importance of exercise and reproductive health planning and implementation. Millions of women and new-borns have died in low-income countries due to impediments that arise before and exaggerate during pregnancies that are not deal with as part of pre-conception care. To the best of our knowledge, however, there is a lack of information about preconception care practice and its determinants in southern Ethiopia, including the study area. This study was therefore planned to evaluate the practice of preconception care and its determinants among mothers who recently gave birth in Wolkite town, southern Ethiopia, in 2020. Mothers who have given birth in the last 12 months have been randomly selected Household wealth status was determined through the application of principal component analysis(PCA). To see the weight of each explanatory variable on PCC, generalized linear regression with a Poisson type was done. Accordingly, the Education status of the mother, time spent to access nearby health facilities, availability of PCC unit, mother’s knowledge on PCC, being a model household, and women’s autonomy in decision making were identified as significant predictors of practice of PCC. Stakeholders must therefore increase their efforts to align PCC units with existing MNCH service delivery points, improve women's decision-making autonomy, and focus on behavioral change communication to strengthen PCC practice.

Preconception care utilization and associated factors among reproductive age women in Mizan-Aman town, Bench Sheko zone, Southwest Ethiopia, 2020. A content analysis

“…Women who travel more than two kilometers were 44% less likely to use preconception care component as compare with counterpart. Similar finding were observed in the study conducted in southern Ethiopia [25]. Sustainable development goal woks for universal access of MNCH continuum of car and strongly advocate access of health care for all [45,46].…”

“…Maternal education were found to be a significant factor for receipt of preconception care service components. This finding also observed in previously conducted studies in Southern Ethiopia, Adet, Northern Ethiopia, Nigeria, China, Sri Lanka and Saudi Arabia [18,[25][26][27][28][29]. This could be due to women with higher level of education have more access to information through reading, searching in internet due to strong information seeking ability which enables them to use more items of PCC.…”

“…The most common item received in the study area was taking micronutrient supplementation (iron and folate) (18.5%), which is lower than a report from a similar study conducted in Mekele city, northern Ethiopia (86.3%) [5],and southern Ethiopia(67.2%) [25] but higher than another study conducted in western Ethiopia (7.7%) [41]. This disparity could be difference in attention of maternal health service in different regions of the country Ethiopia.…”

“…For instance anemia during prenatal(31.8%), hepatitis B virus infection among pregnant women(4.7%), poor dietary practices(60.7%), alcohol consumption during pregnancy at least once per weeks(34%), malnutrition among pregnant women(31.8%), mother-to-child transmission of HIV infection(9.93%) [15][16][17][18][19][20]. Factors identified in previous literatures were age [21][22][23][24], educational status [18,[25][26][27][28][29], wealth [30],maternal knowledge on preconception car [18,[23][24][25][29][30][31][32], planned to pregnancy [18,28,33], positive attitude on preconception care [30] and adverse pregnancy outcome [17,[34][35][36].…”

Level of Maternal Health Literacy (MHL) and Associated Factors among Pregnant Women Attending Antenatal Care Clinics of Public Health Facilities in Southern Ethiopia, 2021: A Facility Based Crossectional Study with Linear Models

“…Women's Decision-Making Autonomy: When a woman decides on at least one of the following 3 things alone or jointly (with her husband), she is said to be autonomous of decision-making power: (1) her own health (personal decision-making authority), (2) economic decision-making authority, and (3) visits friends or relatives (mobility decision-making authority). When her husband or a third party decides on any of the above-mentioned activities, she is considered no autonomous [4,35].…”