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      What do women know before getting pregnant? Knowledge of preconception care and associated factors among pregnant women in Mana district, Southwest Ethiopia: a community-based cross-sectional study

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          Abstract

          Objective

          To assess knowledge of preconception care and associated factors among pregnant women in Mana district, Jimma zone, Oromia Region, Southwest Ethiopia, in 2019.

          Design

          A community-based cross-sectional study was conducted from 2 March to 10 April 2019.

          Setting

          The study was conducted in Mana district. Eight rural Gandas and one urban Ganda were included in the study.

          Participants

          Out of 715 pregnant women in the selected rural Gandas, 553 participated in the study, whereas 70 out of 88 were recruited from the urban Ganda. A total of 623 pregnant women participated in the study.

          Primary and secondary outcome measures

          Women’s knowledge of preconception care was determined. Descriptive statistics were calculated as necessary. Logistic and linear regression analyses were used to identify the association of women’s knowledge of preconception care with explanatory variables.

          Results

          Among 623 respondents, 133 (21.3%) of pregnant women had good knowledge of preconception care. Multivariable linear regression analysis showed that women who attended secondary and above education (β=3.6; p<0.001) and those for whom their husbands attended secondary and above education (β=2.3; p=0.001), planned pregnancy status (β=1.2; p=0.005), being on follow-up for pre-existing medical illnesses (β=1.5; p=0.014) and having four or more antenatal care visits (β=0.4; p=0.016) were significantly associated with women’s knowledge of preconception care.

          Conclusion

          The findings imply that providing health education and health promotion for women is important to improve their level of knowledge of preconception care.

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          Most cited references28

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          Principles and methods of validity and reliability testing of questionnaires used in social and health science researches.

          The importance of measuring the accuracy and consistency of research instruments (especially questionnaires) known as validity and reliability, respectively, have been documented in several studies, but their measure is not commonly carried out among health and social science researchers in developing countries. This has been linked to the dearth of knowledge of these tests. This is a review article which comprehensively explores and describes the validity and reliability of a research instrument (with special reference to questionnaire). It further discusses various forms of validity and reliability tests with concise examples and finally explains various methods of analysing these tests with scientific principles guiding such analysis.
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            Recommendations to improve preconception health and health care--United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care.

            This report provides recommendations to improve both preconception health and care. The goal of these recommendations is to improve the health of women and couples, before conception of a first or subsequent pregnancy. Since the early 1990s, guidelines have recommended preconception care, and reviews of previous studies have assessed the evidence for interventions and documented the evidence for specific interventions. CDC has developed these recommendations based on a review of published research and the opinions of specialists from the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. The 10 recommendations in this report are based on preconception health care for the U.S. population and are aimed at achieving four goals to 1) improve the knowledge and attitudes and behaviors of men and women related to preconception health; 2) assure that all women of childbearing age in the United States receive preconception care services (i.e., evidence-based risk screening, health promotion, and interventions) that will enable them to enter pregnancy in optimal health; 3) reduce risks indicated by a previous adverse pregnancy outcome through interventions during the interconception period, which can prevent or minimize health problems for a mother and her future children; and 4) reduce the disparities in adverse pregnancy outcomes. The recommendations focus on changes in consumer knowledge, clinical practice, public health programs, health-care financing, and data and research activities. Each recommendation is accompanied by a series of specific action steps and, when implemented, can yield results within 2-5 years. Based on implementation of the recommendations, improvements in access to care, continuity of care, risk screening, appropriate delivery of interventions, and changes in health behaviors of men and women of childbearing age are expected to occur. The implementation of these recommendations will help achieve Healthy People 2010 objectives. The recommendations and action steps are a strategic plan that can be used by persons, communities, public health and clinical providers, and governments to improve the health of women, their children, and their families. Improving preconception health among the approximately 62 million women of childbearing age will require multistrategic, action-oriented initiatives.
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              How Do Women Prepare for Pregnancy? Preconception Experiences of Women Attending Antenatal Services and Views of Health Professionals

              Main objective To determine the extent to which women plan and prepare for pregnancy. Methods Cross-sectional questionnaire survey of pregnant women attending three maternity services in London about knowledge and uptake of preconception care; including a robust measure of pregnancy planning, and phone interviews with a range of health care professionals. Main results We recruited 1173/1288 (90%) women, median age of 32 years. 73% had clearly planned their pregnancy, 24% were ambivalent and only 3% of pregnancies were unplanned. 51% of all women and 63% of those with a planned pregnancy took folic acid before pregnancy. 21% of all women reported smoking and 61% reported drinking alcohol in the 3 months before pregnancy; 48% of smokers and 41% of drinkers reduced or stopped before pregnancy. The 51% of all women who reported advice from a health professional before becoming pregnant were more likely to adopt healthier behaviours before pregnancy [adjusted odds ratios for greatest health professional input compared with none were 2.34 (95% confidence interval 1.54–3.54) for taking folic acid and 2.18 (95% CI 1.42–3.36) for adopting a healthier diet before pregnancy]. Interviews with 20 health professionals indicated low awareness of preconception health issues, missed opportunities and confusion about responsibility for delivery of preconception care. Significance of the findings Despite a high level of pregnancy planning, awareness of preconception health among women and health professionals is low, and responsibility for providing preconception care is unclear. However, many women are motivated to adopt healthier behaviours in the preconception period, as indicated by halving of reported smoking rates in this study. The link between health professional input and healthy behaviour change before pregnancy is a new finding that should invigorate strategies to improve awareness and uptake of pre-pregnancy health care, and bring wider benefits for public health.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2020
                23 July 2020
                : 10
                : 7
                : e035937
                Affiliations
                [1]departmentHealth, Behavior and Society , Jimma University , Jimma, Ethiopia
                Author notes
                [Correspondence to ] Mr Firanbon Teshome; firanbonteshome@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-8822-8602
                Article
                bmjopen-2019-035937
                10.1136/bmjopen-2019-035937
                7380725
                32709644
                42f4de22-0083-4b54-82fd-af09aae31996
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 22 November 2019
                : 14 April 2020
                : 17 June 2020
                Categories
                Public Health
                1506
                1724
                Original research
                Custom metadata
                unlocked

                Medicine
                prenatal diagnosis,primary care,preventive medicine,public health
                Medicine
                prenatal diagnosis, primary care, preventive medicine, public health

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