Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia.
Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Reprod Health. 2021 May 21;18(1):100. doi: 10.1186/s12978-021-01154-3.
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.
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.
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.
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.
孕前保健（PCC）是在怀孕前和整个怀孕期间为妇女和夫妇提供的一系列生物医学、心理和心理社会健康服务，以实现理想的结果。由于在怀孕前和怀孕期间没有得到处理的障碍，数以百万计的妇女和新生儿在低收入国家死亡，这些障碍没有作为孕前保健的一部分得到处理。然而，据我们所知，在包括研究区域在内的埃塞俄比亚南部，关于孕前保健实践及其决定因素的信息还很缺乏。因此，本研究旨在评估 2020 年在埃塞俄比亚南部沃尔凯特镇最近分娩的母亲的孕前保健实践及其决定因素。
这是一项基于社区的横断面研究，于 2020 年 2 月 1 日至 30 日进行。随机选择了最近 12 个月内分娩的 600 名母亲。采用两阶段抽样技术。使用预测试的半结构式问卷收集数据。数据经过编码并输入到 Epi-Data 版本 3.1 中，并导出到 SPSS 版本 23 中进行分析。通过主成分分析（PCA）应用来确定家庭财富状况。孕前保健实践被视为计数变量，并以最小得分为 0 和最大得分为 10 来衡量。通过方差分析（ANOVA）和独立 t 检验进行单变量统计分析，具有 p 值<0.05 的变量有资格进行广义线性回归模型。为了观察每个解释变量对 PCC 利用的权重，进行了具有泊松链接的广义线性回归。
在抽样的 600 名参与者中，591 名参与了研究，应答率为 98.8%。PCC 实践的平均（±SD）得分为 3.94（±1.98），最低得分为 0，最高得分为 10。只有 6.4%（95%CI：4.6，8.6）的母亲接受了所有选定的 PCC 服务项目。母亲最常接受的项目是叶酸补充剂，占 67.2%，而母亲接受最少的项目是优化心理健康，占 16.1%。母亲的教育状况[AOR 0.74，95%CI 0.63，0.97]、到达附近卫生设施的时间[AOR 0.69，95%CI 0.58，0.83]、PCC 单位的可用性[AOR 1.46；95%CI 1.17，1.67]、母亲对 PCC 的知识[AOR 1.34，95%CI 1.13，1.65]、作为模范家庭[AOR 1.31，95%CI 1.18，1.52]和妇女在决策中的自主权[AOR 0.75，95%CI 0.64，0.96]被确定为 PCC 实践的重要预测因素。
在当前研究区域发现，接受世界卫生组织（WHO）推荐的 PCC 服务要素的情况并不令人满意。因此，利益相关者必须加大努力，将 PCC 单位与现有的母婴健康服务提供点相匹配，提高妇女的决策自主权，并注重行为改变沟通，以加强 PCC 实践。
