Preconception care knowledge and factors associated with preconception care utilization among married women in South-Eastern community of India: A cohort study.

Abstract

Background: Preconception care (PCC) is a series of biomedical, mental, and psychosocial health services provided to women and a couple before pregnancy and throughout subsequent pregnancies for desired outcomes. various unfavourable pregnancy outcomes continue to be a major health issue in India. PCC services used by mothers have the ability to prevent a great deal of negative consequences. In the Indian healthcare system, the use of this service and its contributing factors are not well understood. Therefore, this study was conducted to assess the utilization and determinants of PCC among recently delivered mothers and barriers of its underutilization.

Methods: A community-based retrospective cohort study was conducted among 391 recently delivered mothers in Khordha district, Odisha, South-Eastern community of India. A two-stage sampling technique was being used to select the desired sample. Data were collected by using a pretested interview schedule and structured questionnaire which included sociodemographic variables, knowledge on preconception health and factors associated with preconception health service utilization. Data were entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis (IBM Corporation, New York, USA). Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables, respectively.

Results: This study revealed that, 59 (15.1%) mothers had used at least one component of the World Health Organization (WHO) package of PCC services before their previous pregnancy, whereas none of them received all ten selected items of WHO package of PCC services. The most commonly used component of PCC in this study was folic acid supplementation, and the least used was utilization of psychological health. Mothers' knowledge on PCC (adjusted odds ratio [AOR]: 24.0; 95% confidence interval [CI]: 12.37, 46.65), husbands having higher education and better employment (AOR: 20.22; 95% CI: 0.80, 510.83), (AOR: 5.31; 95% CI: 0.05, 528.17) respectively, history of adverse birth outcomes (AOR: 0.82; 95% CI: 0.28,0.23), history of preexisting health problems (AOR: 1.31; 95% CI: 1.18, 1.52), husband/partner support (AOR: 2.59;95% CI; 0.70, 9.60) were significantly associated with PCC service utilization.

Conclusions: The utilization of WHO-recommended PCC service packages in the present study area was found to be very poor. Health professionals and stakeholders will be trained and improve PCC practice by integrating PCC service with existing MNCH service. In addition, maternal awareness need to be focused for enhancing PCC utilization for preventing adverse pregnancy outcome.