This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research article
Joan Khavugwi Okemo
Aga Khan University - Kenya
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9924-0041
License:
This work is licensed under a CC BY 4.0 License. Read Full License
BACKGROUND
Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in the rural areas. Little is known regarding PCC use in Kenya that could help in bridging this gap. This study aimed to assess the determinants of PCC in urban and rural settings in Kenya.
METHODS
Selected pregnant women seeking antenatal care (ANC) were recruited by purposive sampling at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed thematically.
RESULTS
A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred after 13 interviews (7 at AKUH and 6 at MLFH).
Transcription, coding and thematic analysis of the IDIs yielded 12 main themes. Eleven of the main themes were identified as determinants of PCC while the twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy.
The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC.
CONCLUSION
From this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of nurses and doctors.
Keywords
Preconception Care, Kenya, Urban, Rural Utilization, Determinants
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CURRENT STATUS: Under Review
Version 1
Posted 12 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 09 Apr, 2021
Review #4 received
Received 08 Apr, 2021
Review #3 received
Received 31 Mar, 2021
Review #2 received
Received 31 Mar, 2021
Reviewer #3 agreed
On 22 Mar, 2021
Reviewer #4 agreed
On 22 Mar, 2021
Reviewer #2 agreed
On 20 Mar, 2021
Review #1 received
Received 03 Mar, 2021
Reviewer #1 agreed
On 11 Feb, 2021
Editor assigned
On 08 Feb, 2021
Reviewers invited
Invitations sent on 08 Feb, 2021
Submission checks complete
On 08 Feb, 2021
Editor invited
On 08 Feb, 2021
First submitted
On 11 Jan, 2021
Metrics
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Subject Areas
Maternal & Fetal Medicine
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This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Joan Khavugwi Okemo
Aga Khan University - Kenya
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9924-0041
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 12 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 09 Apr, 2021
Review #4 received
Received 08 Apr, 2021
Review #3 received
Received 31 Mar, 2021
Review #2 received
Received 31 Mar, 2021
Reviewer #3 agreed
On 22 Mar, 2021
Reviewer #4 agreed
On 22 Mar, 2021
Reviewer #2 agreed
On 20 Mar, 2021
Review #1 received
Received 03 Mar, 2021
Reviewer #1 agreed
On 11 Feb, 2021
Editor assigned
On 08 Feb, 2021
Reviewers invited
Invitations sent on 08 Feb, 2021
Submission checks complete
On 08 Feb, 2021
Editor invited
On 08 Feb, 2021
First submitted
On 11 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
BACKGROUND
Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in the rural areas. Little is known regarding PCC use in Kenya that could help in bridging this gap. This study aimed to assess the determinants of PCC in urban and rural settings in Kenya.
METHODS
Selected pregnant women seeking antenatal care (ANC) were recruited by purposive sampling at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed thematically.
RESULTS
A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred after 13 interviews (7 at AKUH and 6 at MLFH).
Transcription, coding and thematic analysis of the IDIs yielded 12 main themes. Eleven of the main themes were identified as determinants of PCC while the twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy.
The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC.
CONCLUSION
From this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of nurses and doctors.
Figure 1
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