Health Care Providers Perceptions About Preconception Care in Ibadan, Southwest Nigeria: A Qualitative Study

Abstract

Background: Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. Research has shown that PCC services are minimally available and yet to be fully integrated into maternal health services in Nigeria. This study explored the perceptions about PCC services among health care providers in Ibadan, Nigeria. Methods: This was a case study research among 26 health care providers -16 specialist physicians and nine nurses covering 10 specialties: Obstetrics/Gynaecology, Cardiology, Endocrinology among others at the primary, secondary and tertiary health care levels. In-depth interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis. Results: Six main themes were identi ed from the data -scope of PCC, people who require PCC, where PCC services can be provided, acceptability of PCC services, relevance of PCC to different specialties including gynaecologists, cardiologists, nephrologists, psychiatrists and possible bene ts of PCC. PCC was viewed as care for women, men and couples before pregnancy to optimise health status and ensure positive pregnancy outcomes. Almost all participants stated that PCC services should be offered at all three levels of health care with referral when needed from the lower to higher levels. The prevailing opinion on the circumstances when PCC is required was that although all people of reproductive age would bene t, those who had medical problems such as hypertension, sickle cell disease, diabetes and infertility would bene t more. Participants opined that delayed health care seeking observed in the community may in uence acceptability of PCC especially for people without known pre-existing conditions. All specialist physicians identi ed the relevance of PCC to their practice and identi ed potential bene ts of PCC. The potential bene ts outlined included opportunity to plan and prepare for pregnancy to ensure positive pregnancy outcomes. Conclusion: Preconception care is perceived as being more important for promoting positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Provision of the service will however require establishment of guidelines and its uptake will depend on acceptability to people with known medical problems who will bene t from the service.

Provision of Preconception Care by Midwives, Nurses and Doctors at Ndola Teaching Hospital in Ndola District, Zambia

“…In this study, 92.5% (99) respondents had positive attitudes towards preconception care; they perceived it as a way of assisting in prevention of congenital abnormalities through early screening, testing and counselling. Similarly, in a study conducted by Ojifinni and Ibisomi [32] in Nigeria, it was reported that although all people of the reproductive age would benefit from preconception care, those who had medical problems such as hypertension, sickle cell disease, diabetes and infertility would benefit more. The study conducted in Nigeria further identified potential benefits of preconception care that included opportunity to prepare for pregnancy to ensure positive pregnancy outcomes.…”