Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study

Abstract

Background Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. Research has however shown that preconception care services are not routinely provided as part of maternal health services in Nigeria. This study explored the perceptions about preconception care services among health care workers in Ibadan, Nigeria.Methods This was a qualitative descriptive study involving 25 in-depth interviews among 16 specialist physicians and nine nurses covering 10 specialties: Obstetrics/Gynaecology, Cardiology, Endocrinology among others at the primary, secondary and tertiary health care levels. Interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis.Results Six main themes were identified from the data – what PCC is, people who require PCC, where PCC services can be provided, acceptability of PCC services, the relevance of PCC to different specialties including gynaecologists, cardiologists, nephrologists, psychiatrists and the possible benefits of PCC. PCC was viewed as care for women, men and couples before pregnancy to optimise health status and ensure positive pregnancy outcomes. Almost all the participants stated that PCC services should be offered at all three levels of health care with referral when needed from the lower to higher levels. The prevailing opinion on the circumstances when PCC is required was that although all people of reproductive age would benefit, those who had medical problems such as hypertension, sickle cell disease, diabetes and infertility would benefit more. Acceptance and use of PCC services could however be hindered by the attitude of potential clients especially for those without any known pre-existing condition who may not use the service even if they were aware of its existence. All specialist physicians identified the relevance of PCC to their practice and identified potential benefits of PCC. The potential benefits outlined included opportunity to plan and prepare for pregnancy to ensure positive pregnancy outcomes.Conclusion Preconception care is important for positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Its uptake will however depend on its acceptability to the people who will benefit from the service.