Preconception care in sub-Saharan Africa: A systematic review and meta-analysis on the prevalence and its correlation with knowledge level among women in the reproductive age group

Abstract

Objective: Preconception care is aimed to promote optimal health in women before conception to reduce or prevent poor pregnancy outcomes. Although there are several published primary studies from sub-Saharan African countries on preconception care, they need to quantify the extent of preconception care utilization, the knowledge level about preconception care, and the association among women in the reproductive age group in this region. This systematic review and meta-analysis aimed to estimate the pooled utilization of preconception care, pooled knowledge level about preconception care, and their association among women in the reproductive age group in sub-Saharan Africa. Methods: Databases including PubMed, Science Direct, Hinari, Google Scholar, and Cochrane library were systematically searched for relevant literature. Additionally, the references of included articles were checked for additional possible sources. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of preconception care, knowledge level of preconception care, and their correlation among reproductive-aged women in sub-Saharan African countries. Results: Of the identified 1593 articles, 20 studies were included in the final analysis. The pooled utilization of preconception care and good knowledge level about preconception care among women of reproductive age were found to be 24.05% (95% confidence interval: 16.61, 31.49) and 33.27% (95% confidence interval: 24.78, 41.77), respectively. Women in the reproductive age group with good knowledge levels were greater than two times more likely to utilize the preconception care than the women with poor knowledge levels in sub-Saharan African countries (odds ratio: 2.35, 95% confidence interval: 1.16, 4.76). Conclusion: In sub-Saharan African countries, the utilization of preconception care and knowledge toward preconception care were low. Additionally, the current meta-analysis found good knowledge level to be significantly associated with the utilization of preconception care among women of reproductive age. These findings indicate that it is imperative to launch programs to improve the knowledge level about preconception care utilization among women in the reproductive age group in sub-Saharan African countries.

Factors Related to the Implementation of Preconception Care Recommendations in Selected Districts of Limpopo Province: A Qualitative Study

“…The researchers believe that if WCBA are made aware of PCC, most are likely to utilize it and thus improve their perinatal outcomes. The findings of this study echo those of Woldeyohannes [ 26 ] and Okemo et al [ 27 ], who also found that most WCBA were not aware of PCC and thus likely not to use the service. A study by M’hamdi et al [ 28 ] also concluded that a lack of awareness of PCC is a barrier to its utilization.…”

Pregnancy after kidney and liver transplantation

“…While prenatal care is offered for free at all primary healthcare clinics, these services are underutilised in both sub-Saharan Africa and SA. [32,33] Transplant recipients should be counselled on factors associated with good pregnancy outcomes. These include delaying pregnancy for at least 1 year following the transplant, no evidence of graft rejection for at least 1 year prior to conception, stable graft function, absence of acute infections, stable maintenance doses of immunosuppressant drugs, and normal blood pressure.…”

A qualitative analysis of community health worker perspectives on the implementation of the preconception and pregnancy phases of the Bukhali randomised controlled trial

“…Aside from possibly impacting trial outcomes, this finding is concerning for participants' health, as preconception hypertension presents a risk for future cardiovascular disease in mothers [32][33][34], and for adverse outcomes in a potential pregnancy [35][36][37]. The reported undermanagement may reflect a lack of current preconception care within the South African public healthcare system [38][39][40]. In response to this finding, the Bukhali intervention team plans to implement more extensive follow-up of these high-risk, unmanaged cases.…”