Meager Perception of Preconception Care Among Women Desiring Pregnancy in Rural Areas: A Qualitative Study Using Focus Group Discussions

Abstract

Background: India has the second-highest number of under-five deaths in any country in the world. WHO and the Government of India recommended the rollout of preconception care (PCC) to reduce maternal and child mortality. However, very few countries, including India, have started a comprehensive package of PCC services. It implies that women, mainly from rural and tribal areas, are not aware of PCC. PCC has been rolled out through the government health system in two blocks of Nashik district in Maharashtra state, India, among all women who desire to be pregnant within 1 year. This project is the first of its kind in India. To assess basic perceptions, knowledge, and behavior of women on PCC before the implementation of the project, focus group discussions (FGDs) were carried out. The authors think that the finding may help to develop strategies for behavioral change communication.Methods: From each of the four blocks, two villages having subcenter were selected for conducting FGD. A house-to-house survey was conducted by Accredited Social Health Activist (ASHA) to enlist women who desire a baby in 1 year and invite them to subcenter for FGDs, which were conducted in June 2018.Results: A total of 76 women having a mean age of 23.97 years participated in the FGDs. Most of them (46.05%) had completed 10 years of education. About 50% of pregnancies were planned. The decision about the timing of the first pregnancy is influenced by the mother-in-law. Women knew that they should not conceive before 20 years of age, and their suboptimal weight may have an adverse impact on the health of the newborn. There are many myths about food like “hot and cold foods” and “forbidden food” etc. Women had some knowledge about the adverse effects of tobacco and alcohol; very few consumed these. Most of them did not practice behaviors or accessed services related to PCC.Conclusions: Women neither have the knowledge nor adopt behaviors or accessed services related to PCC. Roll out of PCC among them may help in further reduction of maternal and neonatal morbidity and mortality in India.

Preconception care knowledge and information delivery modes among adolescent girls and women: a scoping review

“…As can be seen in Table 1 , all included articles were from 2018 and beyond, and four were from 2021. Of the eight selected studies, five were conducted in low- to middle-income countries (Ethiopia, Indonesia, India, and Nigeria) [ 13 , 15 , 17 - 19 ], and three were from high-income countries (the United States, Japan, and Australia) [ 12 , 14 , 16 ]. These findings indicated the increased interest in PCC research following a better understanding of PCC’s importance for women’s and children’s health across the globe.…”

“…Although research in Ethiopia showed that many pregnant women understood human immunodeficiency virus screening, family planning, and hypertension screening, only a few were aware of folic acid and iron consumption and hepatitis B screening, as PCC information was usually provided by health workers only during antenatal visits [ 17 ]. A qualitative study in India also reported that of 76 women (aged 15 to 39 years) who participated in focus group discussions, most were well acquainted with the basic concepts of PCC, such as nutrition pre-pregnancy and the effects of tobacco and alcohol effects, but only a few were aware of the need of good mental health, PCC programs, sexually transmitted infections, and the effect of chronic medical conditions; furthermore, 50% had an unplanned pregnancy and most did not access PCC services [ 19 ].…”

“…During the reading, 104 articles were excluded as they did not meet the article selection criteria (e.g., guidelines, protocol articles) (Figure 1). Finally, eight studies [12][13][14][15][16][17][18][19] were included in this review study.…”

Perceptions of and challenges faced by primary healthcare workers about preconception services in rural India: A qualitative study using focus group discussion

“…This study is a part of a comprehensive intervention study that broadly aims to reduce low birth weight and preterm births by addressing the known risk factors in the preconception period. The knowledge and behavior among women desiring pregnancy regarding preconception care are reported elsewhere ( 41 ).…”

Universalization of preconception care: Need of the day

“…Planning of pregnancy not only by the couple but the family as such is necessary. The dominant role of the mother-in-law cannot be (11) neglected . The estimated proportion of unintended (12) pregnancies may be about 50% .…”