Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria

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Study Justification:
– Preconception care (PCC) is a preventive strategy for reducing maternal and perinatal morbidity and mortality.
– The level of awareness and utilization of PCC services in low-income countries like Nigeria is unknown or very low.
– This study aimed to assess the level of awareness and utilization of PCC services in Abakaliki, Nigeria.
Study Highlights:
– A descriptive cross-sectional survey was conducted at a teaching hospital.
– 450 participants responded to interviewer-administered questionnaires.
– 44.2% of participants were aware of PCC, 31.7% had good knowledge, and only 10.3% received PCC.
– Health care providers were the main source of information (77.9%).
– There was a statistically significant correlation between awareness/utilization and participants’ level of education, residence, and information from doctors.
– The study revealed a low level of awareness and poor utilization of PCC in Abakaliki, Nigeria.
Recommendations for Lay Reader and Policy Maker:
– Scale up health education to improve awareness and knowledge about PCC.
– Establish functional PCC clinics to increase access to PCC services.
– Formulate evidence-based guidelines to guide the provision of PCC.
– Improve social infrastructures to enhance awareness, access, and utilization of PCC.
– Introduce interventions aimed at improving the uptake of PCC and pregnancy outcomes.
Key Role Players:
– Health care providers: They play a crucial role in providing information and delivering PCC services.
– Educators: They can contribute to health education programs and initiatives.
– Policy makers: They are responsible for formulating guidelines and allocating resources for PCC.
– Community leaders: They can help in raising awareness and promoting the importance of PCC.
Cost Items for Planning Recommendations (Budget Items):
– Development and implementation of health education programs.
– Training and capacity building for health care providers.
– Establishment and maintenance of functional PCC clinics.
– Research and development of evidence-based guidelines.
– Infrastructure improvement in healthcare facilities.
– Community engagement and awareness campaigns.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study conducted a descriptive cross-sectional survey with a sample size of 450 participants, which provides a reasonable amount of data. The study identified the level of awareness and utilization of preconception care (PCC) services in Abakaliki, Nigeria. The findings showed a low level of awareness and poor utilization of PCC, and identified socio-demographic factors that influenced awareness and utilization. The study suggests actionable steps to improve PCC uptake, such as scaling up health education, establishing functional PCC clinics, and formulating evidence-based guidelines. To improve the strength of the evidence, future research could include a larger sample size, use a longitudinal design to assess the impact of interventions, and consider potential confounding factors.

Preconception care (PCC) is a preventive strategy for maternal and perinatal morbidity and mortality. This study aimed to assess the level of awareness and utilisation of PCC services. A descriptive cross-sectional survey was conducted at a teaching hospital. Interviewer-administered questionnaires were used to extract information. A total of 450 participants responded; 44.2% (190/450) were aware, 31.7% (143/450) had good knowledge, while only 10.3% (46/450) received PCC. Health care providers were the main source of information (77.9%). There was statistically significant correlation between awareness and participants’ level of education (p <.001) and residence (p <.001), as well as between utilisation and education (p <.001), and information from doctors (p <.001). There was a low level of awareness and poor utilisation of PCC, underpinning the need to scale up health education, establishment of functional PCC clinics and formulation of evidence-based guidelines to improve uptake and pregnancy outcome.Impact statementWhat is already known on the subject of the paper? PCC has been known in high-income countries as a prevention-based strategy, which aims at improving obstetric outcomes. However, the level of utilisation in low-income countries like Nigeria is either unknown or far too low. What do this study add? This work has provided local data on PCC; clearly indicating that the awareness and utilisation of PCC services in Abakaliki, Nigeria is very low when compared with other regions of the world, and this was influenced by the socio-demographic factors–particularly education and place of residence (for awareness), and level of education and information from health care providers (for utilisation), thus suggesting that enlightenment and improvement in social infrastructures could improve awareness, access and utilisation of PCC. What are the implications for clinical practice and/or further research? The implications of these findings in low resource settings like ours will include introducing interventions to scaling up health education, universal establishment of functional PCC units and formulation of evidence-based guidelines aimed at improving the uptake of PCC and pregnancy outcome. Further research will also be needed in future to assess the impact of such interventions and how to sustain potential benefits.

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The study titled “Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria” highlights the low level of awareness and utilization of preconception care (PCC) services in Nigeria. The study suggests several recommendations to improve access to maternal health:

1. Scaling up health education: Increasing awareness about the importance of PCC through targeted health education campaigns can help improve access to maternal health. This can be done through community outreach programs, media campaigns, and educational materials.

2. Establishment of functional PCC clinics: Creating dedicated PCC clinics within healthcare facilities can provide women with easy access to comprehensive preconception care services. These clinics can offer counseling, screening, and interventions to address potential risks and improve pregnancy outcomes.

3. Formulation of evidence-based guidelines: Developing and implementing evidence-based guidelines for PCC can standardize care and ensure that women receive appropriate interventions and screenings. These guidelines should be based on the latest research and tailored to the local context.

4. Improving social infrastructures: Enhancing social infrastructures, such as transportation systems and healthcare facilities, can help overcome barriers to accessing maternal health services. This may involve improving road networks, increasing the number of healthcare facilities, and ensuring availability of essential resources and equipment.

5. Further research and evaluation: Conducting additional research to assess the impact of interventions aimed at improving PCC uptake and pregnancy outcomes is crucial. This will help identify effective strategies and guide future efforts to sustain and enhance the benefits of PCC.

By implementing these recommendations, it is hoped that access to maternal health services, specifically preconception care, can be improved in Nigeria, leading to better pregnancy outcomes and reduced maternal and perinatal morbidity and mortality.
AI Innovations Description
The study titled “Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria” highlights the low level of awareness and utilization of preconception care (PCC) services in Nigeria. The study suggests several recommendations to improve access to maternal health:

1. Scaling up health education: Increasing awareness about the importance of PCC through targeted health education campaigns can help improve access to maternal health. This can be done through community outreach programs, media campaigns, and educational materials.

2. Establishment of functional PCC clinics: Creating dedicated PCC clinics within healthcare facilities can provide women with easy access to comprehensive preconception care services. These clinics can offer counseling, screening, and interventions to address potential risks and improve pregnancy outcomes.

3. Formulation of evidence-based guidelines: Developing and implementing evidence-based guidelines for PCC can standardize care and ensure that women receive appropriate interventions and screenings. These guidelines should be based on the latest research and tailored to the local context.

4. Improving social infrastructures: Enhancing social infrastructures, such as transportation systems and healthcare facilities, can help overcome barriers to accessing maternal health services. This may involve improving road networks, increasing the number of healthcare facilities, and ensuring availability of essential resources and equipment.

5. Further research and evaluation: Conducting additional research to assess the impact of interventions aimed at improving PCC uptake and pregnancy outcomes is crucial. This will help identify effective strategies and guide future efforts to sustain and enhance the benefits of PCC.

By implementing these recommendations, it is hoped that access to maternal health services, specifically preconception care, can be improved in Nigeria, leading to better pregnancy outcomes and reduced maternal and perinatal morbidity and mortality.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health, a mixed-methods approach could be employed. Here is a brief description of the methodology:

1. Quantitative Data Collection: A survey could be conducted among a representative sample of women of reproductive age in Abakaliki, Southeast Nigeria. The sample size should be determined using appropriate statistical methods to ensure adequate power. The survey should include questions related to awareness and utilization of preconception care (PCC) services, as well as socio-demographic factors such as education level and place of residence. This data can be collected using interviewer-administered questionnaires, similar to the original study.

2. Qualitative Data Collection: In-depth interviews or focus group discussions could be conducted with a subset of survey participants to gain a deeper understanding of their experiences and perceptions regarding PCC services. This qualitative data can provide valuable insights into the barriers and facilitators of accessing maternal health services.

3. Intervention Implementation: Based on the recommendations outlined in the abstract, interventions can be implemented in the study area. These interventions may include scaling up health education through targeted campaigns, establishing functional PCC clinics within healthcare facilities, formulating evidence-based guidelines for PCC, and improving social infrastructures such as transportation systems and healthcare facilities.

4. Post-Intervention Data Collection: After a sufficient period of time has passed for the interventions to take effect, a follow-up survey can be conducted using the same methodology as the initial survey. This will allow for the assessment of changes in awareness and utilization of PCC services, as well as any improvements in pregnancy outcomes.

5. Data Analysis: The quantitative data collected before and after the interventions can be analyzed using appropriate statistical methods, such as chi-square tests or logistic regression, to assess the impact of the interventions on improving access to maternal health. The qualitative data can be analyzed thematically to identify common themes and patterns related to the barriers and facilitators of accessing PCC services.

6. Evaluation and Recommendations: Based on the findings from the data analysis, an evaluation of the interventions can be conducted. This evaluation should assess the effectiveness and feasibility of the interventions in improving access to maternal health. Recommendations can then be made for scaling up successful interventions and addressing any remaining challenges.

By following this methodology, researchers can assess the impact of the main recommendations outlined in the abstract on improving access to maternal health in Abakaliki, Southeast Nigeria. This will provide valuable insights for policymakers and healthcare providers to guide future efforts in enhancing maternal health services.

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