1
|
Mekonnen BD, Tsega SS. Association between preconception care and family planning and previous adverse birth outcomes in Ethiopia: systematic review and meta-analysis. BMJ Open 2024; 14:e078299. [PMID: 38719286 PMCID: PMC11086204 DOI: 10.1136/bmjopen-2023-078299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 04/28/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES Inconsistent findings on the associations of preconception care with the utilisation of family planning and previous adverse birth outcomes have not been systematically reviewed in Ethiopia. Thus, this review aims to estimate the pooled association of preconception care with the utilisation of family planning and previous adverse birth outcomes in Ethiopia. DESIGN Systematic review and meta-analysis of observational studies. DATA SOURCES MEDLINE Complete, CINAHL Complete, Scopus and Global Health were searched from inception to 28 July 2023. ELIGIBILITY CRITERIA Observational studies that reported preconception care as an outcome variable and the use of family planning before pregnancy or previous adverse birth outcomes as exposure variables were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently conducted study screening, data extraction and quality assessment. A fixed-effects model was used to determine the pooled association of preconception care with the utilisation of family planning and previous adverse birth outcomes. RESULTS Eight studies involving a total of 3829 participants were included in the review. The pooled meta-analysis found that women with a history of family planning use had a higher likelihood of using preconception care (OR 2.09, 95% CI 1.74 to 2.52) than those women who did not use family planning before their current pregnancy. Likewise, the pooled meta-analysis found that women with prior adverse birth outcomes had a higher chance of using preconception care (OR 3.38, 95% CI 1.06 to 10.74) than women with no history of prior adverse birth outcomes. CONCLUSION This review indicated that utilisation of preconception care had a positive association with previous use of family planning and prior adverse birth outcomes. Thus, policymakers and other relevant stakeholders should strengthen the integration of preconception care with family planning and other maternal healthcare services. PROSPERO REGISTRATION NUMBER CRD42023443855.
Collapse
Affiliation(s)
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
2
|
Withanage NN, Botfield JR, Black KI, Mazza D. Improving the provision of preconception care in Australian general practice through task-sharing with practice nurses. Aust J Prim Health 2023; 29:217-221. [PMID: 36529180 DOI: 10.1071/py22161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/23/2022] [Indexed: 07/20/2023]
Abstract
Preconception care (PCC) is effective in reducing modifiable risk factors and optimising maternal health. Primary care services such as general practices in Australia are an appropriate setting to provide PCC. However, PCC is not routinely provided in most of these settings, and many reproductive-aged women and men are not aware of the need for PCC. In this forum article, we discuss the factors that hinder PCC provision in Australian general practices and make recommendations on how access to PCC services can be broadened in Australia, including the potential opportunity for general practice nurses to contribute to the provision of PCC.
Collapse
Affiliation(s)
- Nishadi N Withanage
- SPHERE NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Vic., Australia; and Department of General Practice, Monash University, 553 St Kilda Road, Melbourne, Vic., Australia
| | - Jessica R Botfield
- SPHERE NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Vic., Australia; and Department of General Practice, Monash University, 553 St Kilda Road, Melbourne, Vic., Australia
| | - Kirsten I Black
- SPHERE NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Vic., Australia; and University of Sydney, Camperdown, NSW, Australia
| | - Danielle Mazza
- SPHERE NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Vic., Australia; and Department of General Practice, Monash University, 553 St Kilda Road, Melbourne, Vic., Australia
| |
Collapse
|
3
|
Woldeyohannes D, Tekalegn Y, Sahiledengle B, Hailemariam Z, Erkalo D, Zegeye A, Tamrat H, Habte A, Tamene A, Endale F, Ertiban B, Ejajo T, Kelbiso L, Liranso L, Desta F, Ermias D, Mwanri L, Enticott JC. Preconception care in sub-Saharan Africa: A systematic review and meta-analysis on the prevalence and its correlation with knowledge level among women in the reproductive age group. SAGE Open Med 2023; 11:20503121231153511. [PMID: 36819933 PMCID: PMC9929922 DOI: 10.1177/20503121231153511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/09/2023] [Indexed: 02/16/2023] Open
Abstract
Objective Preconception care is aimed to promote optimal health in women before conception to reduce or prevent poor pregnancy outcomes. Although there are several published primary studies from sub-Saharan African countries on preconception care, they need to quantify the extent of preconception care utilization, the knowledge level about preconception care, and the association among women in the reproductive age group in this region. This systematic review and meta-analysis aimed to estimate the pooled utilization of preconception care, pooled knowledge level about preconception care, and their association among women in the reproductive age group in sub-Saharan Africa. Methods Databases including PubMed, Science Direct, Hinari, Google Scholar, and Cochrane library were systematically searched for relevant literature. Additionally, the references of included articles were checked for additional possible sources. The Cochrane Q test statistics and I 2 tests were used to assess the heterogeneity of the included studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of preconception care, knowledge level of preconception care, and their correlation among reproductive-aged women in sub-Saharan African countries. Results Of the identified 1593 articles, 20 studies were included in the final analysis. The pooled utilization of preconception care and good knowledge level about preconception care among women of reproductive age were found to be 24.05% (95% confidence interval: 16.61, 31.49) and 33.27% (95% confidence interval: 24.78, 41.77), respectively. Women in the reproductive age group with good knowledge levels were greater than two times more likely to utilize the preconception care than the women with poor knowledge levels in sub-Saharan African countries (odds ratio: 2.35, 95% confidence interval: 1.16, 4.76). Conclusion In sub-Saharan African countries, the utilization of preconception care and knowledge toward preconception care were low. Additionally, the current meta-analysis found good knowledge level to be significantly associated with the utilization of preconception care among women of reproductive age. These findings indicate that it is imperative to launch programs to improve the knowledge level about preconception care utilization among women in the reproductive age group in sub-Saharan African countries.
Collapse
Affiliation(s)
- Demelash Woldeyohannes
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia,Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Melbourne, Australia,Demelash Woldeyohannes, School of Public Health, College of Medicine and Health Science, Wachemo University, Hossana 554, Ethiopia.
| | - Yohannes Tekalegn
- Department of Public Health, College Health Science, Madda Walabu University, Robe, Ethiopia
| | - Biniyam Sahiledengle
- Department of Public Health, College Health Science, Madda Walabu University, Robe, Ethiopia
| | - Zeleke Hailemariam
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Desta Erkalo
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Abraham Zegeye
- Department of Surgery, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Habtamu Tamrat
- Department of Orthopedic Surgery, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Akililu Habte
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Aiggan Tamene
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Fitsum Endale
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Biruk Ertiban
- Department of Surgery, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Tekle Ejajo
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Lolamo Kelbiso
- School of Nursing, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Lombamo Liranso
- Department of Obstetrics and Gynecology, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Fikreab Desta
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Dejene Ermias
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hosaena, Ethiopia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Joanne C. Enticott
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Melbourne, Australia
| |
Collapse
|
4
|
Ukoha WC, Mtshali NG, Adepeju L. Current state of preconception care in sub-Saharan Africa: A systematic scoping review. Afr J Prim Health Care Fam Med 2022; 14:e1-e11. [PMID: 35532112 PMCID: PMC9082216 DOI: 10.4102/phcfm.v14i1.3096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background Preconception care (PCC) utilisation is essential to extend and complete the health continuum. However, these services are not yet incorporated into many low-income countries’ existing maternal health services. Aim This study aims to review the current literature on the knowledge, utilisation and provision of PCC. Setting This included women and healthcare workers (HCWs) in Sub-Saharan African (SSA) countries. Methods Arksey and O’Malley’s scoping review methodology framework is used in this study. The following databases, Google Scholar, Science Direct, PubMed, Scopus and Dissertation via ProQuest, were searched. Articles that met the eligibility criteria were included in this study. Results Out of the 451 retrieved articles, 39 were relevant. In most studies, women’s utilisation and HCW’s provision of PCC were considered limited. Their knowledge, however, varies between studies, and there were a few studies conducted among women with chronic conditions. Several factors influenced women and HCWs’ knowledge, utilisation and provision of PCC, including age, level of education, employment, practice area, resources and knowledge. Preconception care interventions most commonly identified, utilised and provided were HIV testing, counselling and family planning, while preconception folic acid supplementation was the least. Conclusion The estimates of knowledge and utilisation were suboptimal among women, while provision was the worst affected among HCWs. Gaps exist between the HCW knowledge and practice of PCC. There is a need to promote, prioritise, integrate and optimise the opportunistic provision of PCC in SSA. There is also a need for more studies on PCC provision and utilisation among women with chronic medical conditions.
Collapse
Affiliation(s)
- Winifred C Ukoha
- School of Nursing and Public Health, College of Health Science, University of KwaZulu-Natal, Durban.
| | | | | |
Collapse
|