Preconception care is biomedical, social, and behavioural care provided for a woman or couple before conception occurs or throughout their reproductive year. In Ethiopia, it’s reported that the majority of health care providers had poor knowledge and practice of preconception care. The institution-based cross-sectional study was conducted among 359 obstetric care providers to assess knowledge, attitude, and practice of preconception care in West Shoa Zone, Ethiopia. A stratified, simple random sampling technique selected five hospitals, 46 health centers, and study participants. Pretested and structured questionnaires were used to collect data. Data were entered into Epidata and exported to SPSS for analysis. Bivariate and multivariate logistic regressions were employed to identify an association between the independent predictors and the outcome variables. In this study, 173 (48.2%) and 124(34.5%) of the obstetric care providers had good knowledge and practice of preconception care, respectively. Two-thirds 255(71%) of providers had a favorable attitude toward preconception care. The odds of having good knowledge were higher among Midwives’ providers [AOR: 2.03, 95%CI: 1.09-3.77] and had training on HIV testing [AOR: 3.5, 95%CI: 1.9-6.4]. The presence of a library [AOR: 1.7, 95%CI: 1.04-2.85] and internet access [AOR: 3.4, 95%CI: 2.0-5.8] in working health facility had a higher odds of good knowledge about preconception. Degree and above holders [AOR: 3.1, 95%CI: 1.5-6.1] also had higher odds of good preconception knowledge than diploma holders. Similarly, the odds of having good practice of preconception care were higher among health care providers: who did screening for reproductive life plans [AOR: 3.7, 95%CI:1.8-7.4], worked in maternity and child health unit [AOR:4.2,95%CI:2.0-8.6], perceive all health facilities should give preconception care services [AOR:2.3,95%CI:1.2-4.3], and perceive all health care providers should provide preconception services [AOR:3.0, 95%CI: 1.7-5.5]. This study found that more than half of obstetric care providers’ had poor knowledge, favorable attitude, and poor practice of preconception care. Provision of training, carrier development, and installation of internet and library services should be enhanced.
An institution-based cross-sectional study was conducted in West Shoa Zone, Oromia regional state, from August 1 to September 8, 2021. West Shoa Zone is one of the zones in the Oromia Region of Ethiopia. Its administrative city is Ambo town, located 114 kilometers away from the capital city of Ethiopia, Addis Ababa. The West Shoa Zone has 9 Public Hospitals, 92 health centers, and 529 health posts. About 1,085 obstetric care providers were working in maternity and reproductive care units of the Zone. Among those 11 were Obstetricians and Gynecologists, 21 Integrated Emergency Surgical Officers (IESO), 38 General Practitioners, 426 Midwives, 467 nurses, and 222 Health Officers. About 268 OBCPs worked in hospitals during the data collection period, while 817 worked in Health Centers. All obstetric care providers working in the public health facilities of West Shoa Zone during the study period were considered the source population. In contrast, all obstetric care providers working in West Shoa Zone’s selected public health facilities were considered the study population. In addition to this, all obstetric care providers working in public health facilities of West Shoa Zone during the data collection period were included in the study, and those OBCPs who served for less than six months were excluded from the study. The sample size for the first two specific objectives: to determine knowledge and preconception care practice among obstetrics care providers, was calculated by a single population proportion formula n = (Z α/2)2 P (1-P)/d2 based on the following assumptions: the proportion (P) of knowledge and practice were 31% [11] and 19.2% [15] respectively which was taken from the previous studies, 95% confidence level of Z α/2 = 1.96, 5% of absolute precision. Thus, a 10% non-response rate gave 362 and 262, respectively, and the final sample size became 362. The facilities were stratified into hospitals and health centers. With a simple random sampling technique, 5(N = 157) hospitals and 46(N = 401) health centers were selected. The sample was allocated to each stratum proportionally based on the number of health care providers working at the selected hospitals and health centers, 157/558*362 = 102 OBCPs from hospitals and 401/558*362 = 260 OBCPs from health centers. Then, a simple random sampling technique was used to select study participants. The data were collected using structured self-administered questionnaires. The questionnaire was adapted from a previous study conducted in Ethiopia [11] and had five sections (socio-demographic information, knowledge, attitude and practice, and associated factors of preconception care questions). The knowledge section had 15 knowledge-related questions. A 1 and 0 were given for correct and incorrect answers, respectively. Then, HCPs who scored ≥ 50th percentile were considered good knowledge of PCC. The practice section had 34 questions with three PCC practice components measuring the frequency of practice in the last six months of the period. Each question have an option response of never = 0, rarely = 1, sometimes = 2, often = 3, and always = 4. This gives a minimum score of 34*0 = 0 to the maximum score of 34*4 = 136. In this study, those OBCPs who scored ≥ 50% were considered good PCC practice; otherwise poor. Similarly, the OBCPs’ attitudes were assessed by their level of agreement on nine questions using the Likert scale. Those OBCPs who scored 60% and above the possible maximum score were considered OBCPs with a favorable attitude towards PCC; otherwise, they were considered OBCPs with an unfavorable attitude toward PCC. The questionnaires were disseminated to the OBCPs and facilitated by six trained graduated unemployed nurses and supervised by two senior BSc midwives. To assure quality of the study, data collectors and supervisors were given two days of training about the study materials and data collection procedures. Before actual data collection, the study tool was pre-tested among 18 OBCPs working at Tulu Bolo hospital in South West Shoa Zone, Ethiopia. The tool’s reliability was checked for its internal consistency with a Cronbach’s α test, 0.802 and 0.97 for knowledge and practice, respectively. Moreover, the completeness and consistency of the collected data were reviewed and checked by supervisors and investigators. Obstetric care providers. Certified obstetricians and gynecologists, general practitioners, integrated emergency surgical officers, nurses, midwives, and public health officers working in maternal and reproductive health care units [16]. Knowledge of PCC. Respondents who scored less than the 50th percentile of the knowledge-related items were categorized as HCPs with `poor PCC knowledge.’ In contrast, HCPs who scored ≥ 50th percentile were considered good knowledge of PCC [12]. Attitude towards PCC. Attitude was measured using nine questions with possible five-point Likert scale responses. Those OBCPs who scored 60% and above the possible maximum score [5*9 = 45] were considered OBCPs with a favorable attitude towards PCC; otherwise, they were considered OBCPs with unfavorable attitudes towards PCC. OBCP’s PCC practice. OBCPs who scored < 50% of PCC practice items were classified as practitioners demonstrating poor PCC practice. Those OBCPs who scored ≥ 50% were considered good PCC practice [14]. The collected data were cleaned, coded, and entered into the Epidata version 3.1 and exported to SPSS version 20. Coding was reversed in negative statements. The frequency, proportion, mean, and standard deviation were performed for dependent and independent variables. Binary logistic regression was done to identify candidate variables for multiple logistic regressions. Then those candidate variables were analyzed with multivariate logistic regression, and those variables at a p-value of < 0.05 were considered to have a statistically significant association with the outcome variables. Odds ratios with 95%CI were used to test the strength of association. Multicollinearity assumption was checked by the variance inflation factor (VIF) of < 1.2, which indicated a less likely correlation between independent variables. The models’ goodness of fit was tested using the Hosmer-Lemeshow test, and it was a good fit. The ethical approval was obtained from Ambo University ethical review board. Written Informed consent was obtained from each participant. The participants were assured that participation in the study was voluntary and that they could withdraw during the study. The collected raw data was kept confidential in a secure place, and the names of the participants were not written in the study record. Participants’ rights to anonymity and confidentiality were fully protected. All of the information given by participants was recorded in a manner that did not link the respondents with the data.
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