Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study

Abstract 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 P...

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Autores principales:	J. K. Okemo, D. Kamya, A. M. Mwaniki, M. Temmerman
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Preconception care Kenya Urban Rural Utilization Determinants Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/4abb36d561094b3f8db3e37c1858ec7d
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spelling	oai:doaj.org-article:4abb36d561094b3f8db3e37c1858ec7d2021-11-14T12:32:43ZDeterminants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study10.1186/s12884-021-04201-w1471-2393https://doaj.org/article/4abb36d561094b3f8db3e37c1858ec7d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12884-021-04201-whttps://doaj.org/toc/1471-2393Abstract 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 rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya. Methods A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The study was conducted from May to October 2017. Selected pregnant women seeking antenatal care (ANC) were recruited by quota 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). The interviews were thereafter transcribed verbatim and analyzed thematically. Findings A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred with 13 interviews (7 at AKUH and 6 at MLFH). Transcription, coding and thematic analysis of the IDIs yielded 12 themes. Eleven of these themes were identified as determinants of PCC. 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 the later.J. K. OkemoD. KamyaA. M. MwanikiM. TemmermanBMCarticlePreconception careKenyaUrbanRuralUtilizationDeterminantsGynecology and obstetricsRG1-991ENBMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Preconception care Kenya Urban Rural Utilization Determinants Gynecology and obstetrics RG1-991
spellingShingle	Preconception care Kenya Urban Rural Utilization Determinants Gynecology and obstetrics RG1-991 J. K. Okemo D. Kamya A. M. Mwaniki M. Temmerman Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study
description	Abstract 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 rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya. Methods A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The study was conducted from May to October 2017. Selected pregnant women seeking antenatal care (ANC) were recruited by quota 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). The interviews were thereafter transcribed verbatim and analyzed thematically. Findings A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred with 13 interviews (7 at AKUH and 6 at MLFH). Transcription, coding and thematic analysis of the IDIs yielded 12 themes. Eleven of these themes were identified as determinants of PCC. 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 the later.
format	article
author	J. K. Okemo D. Kamya A. M. Mwaniki M. Temmerman
author_facet	J. K. Okemo D. Kamya A. M. Mwaniki M. Temmerman
author_sort	J. K. Okemo
title	Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study
title_short	Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study
title_full	Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study
title_fullStr	Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study
title_full_unstemmed	Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study
title_sort	determinants of preconception care among pregnant women in an urban and a rural health facility in kenya: a qualitative study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/4abb36d561094b3f8db3e37c1858ec7d
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Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study

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