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Women’s knowledge and associated factors in preconception care in adet, west gojjam, northwest Ethiopia: a community based cross sectional study

  • Yitayal Ayalew1Email author,
  • Amlaku Mulat2,
  • Mulugeta Dile1 and
  • Amare Simegn1
Reproductive Health201714:15

https://doi.org/10.1186/s12978-017-0279-4

Received: 21 October 2016

Accepted: 4 January 2017

Published: 25 January 2017

Abstract

Background

Preconception care is the provision of biomedical, behavioural and social health interventions to women and couples before the occurrence of conception to improve their health status. There is poor maternal and child health and lack of knowledge in developing countries about preconception care. Therefore, this study aimed to assess women’s knowledge and associated factors in preconception care in Adet Town, Gojjam, Northwestern Ethiopia.

Methods

A community based cross-sectional study was conducted among 422 systematically selected reproductive age group women who are living in the Adet town from March 1 to 30, 2016. The data were collected using pre tested and structured questionnaires through face-to-face interviews. The data were entered into Epi-Info version 3.5, and cleaned and analysed using SPSS version 20. Descriptive summary of the data and logistic regression were used to identify possible predictors using odds ratio with 95% confidence interval and P-value of 0.05.

Results

The study revealed that the overall knowledge of preconception care was 27.5% (95% CI: 23.2, 32.0). Women who attended secondary educational and whose age is from 25 to 34 years were more likely to have better knowledge on preconception care than their counterparts were; (AOR 6.52, CI 2.55, 16.69) and (AOR 4.10, CI 1.78, 9.44) respectively. However, Women who had no history of family planning use were 85% less knowledgeable than those who had a history of family planning use (AOR: 0.15; 95% CI: 0.05, 0.44).

Conclusions

In this finding level of women’s knowledge of preconception care is relatively low. Having a history of family planning use, having high levels of educational status, and being older age were associated with good knowledge. This finding suggests that there is a need to give emphasis and deliver health education about preconception care for women in order to increase their knowledge.

Keywords

Preconception care Awareness Reproductive age group women Adet Ethiopia

Plain english summary

According to World Health Organization, preconception health care is an essential component of reproductive health which focuses on the conditions and risk factors that could affect a woman if she became pregnant.

In this study, respondents were asked via close ended and structured questionnaire face to face interviews whether or not they know preconception health care services.

Of the total 422 respondents, more than half of participants 251 (59.5%) were married and 113 (26.8%) of women were housewives.

The finding revealed that only 27.5% of of the respondents had knowledge of preconception care.

The possible determinants identified were: being educated, having a history of contraceptive use, and age.

In conclusion, women’s knowledge of preconception care is relatively low In Adet Town. This finding suggests that there is a need to give emphasis and deliver health education about preconception care for women in order to increase their knowledge.

Background

Preconception care (PCC) is the provision of biomedical, behavioural and social health interventions to women and couples before the occurrence of conception and aims at improving their health status, and reducing behaviours and individual and environmental factors that contribute to poor maternal and child health outcomes [1]. It is imperative that preconception care is seen as an earlier opportunity, not just for family planning or to reduce maternal and neonatal mortality, but also to improve long-term outcomes for adolescent girls, women, and children. Adolescents’ general health and reproductive health must increasingly be considered as crucial stages in the continuum of care. Preconception care is widely recognized as a way to optimize women’s health through biomedical and behavioural changes prior to conception, ultimately to improve pregnancy outcomes [2]. In terms of prevention, PCC is primary prevention for the future baby and secondary prevention for prospective mothers [3].

Preconception care is important to reduce several risk behaviours and exposures that can affect fetal development and subsequent outcomes [4]. Therefore, it should be planned to address reproductive system problems, to reduce environmental hazards, toxins and medications that are known teratogens, to promote nutrition and folic acid intake, to advise on weight management, to detect problems related to genetic conditions, family history, substance use, chronic diseases and infectious diseases, to advise on vaccinations, family planning, psychosocial concern, domestic violence, and housing.

Despite the interventions in place, progress in maternal and child health outcomes over the last 20 years has been slow globally. Studies showed that less than 1/3rd of women of childbearing age visited the health institutions and speak with a health care provider prior to pregnancy about their health status and its potential impact on pregnancy outcome [5].

As of 2011 sub-Saharan Africa report on maternal health shows that in sub-Saharan Africa there is a poor preconception care practice and this is due to low economic status, lack of health care providers, being illiterate and poor awareness about maternal health including preconception care [6]. Preconception care (PCC) is the most important maternal health care service to reduce maternal and child mortality and morbidity by identifying and treating any risks early, promoting health, and preventing disease. In addition to this, PCC highly associated with increase antenatal care, delivery care and post natal care service utilizations which are the corner store to improve maternal and child health [7].

Different articles show that the women’s preconception care knowledge and practice in developing countries including Africa is low. Studies conducted in Sri Lanka, Nigeria and Sudan showed that the women’s level of knowledge regarding with preconception care is very low [811].

Worldwide, there are different literatures done in order to assess factors associated with women’s knowledge in preconception care and they revealed that women’s knowledge regarding to preconception care was affected by women’s age, ethnicity, occupation, educational status, pregnancy intention, previous history of abortion, monthly income, previous history of stillbirth, parity and family planning [1214].

Preconception care is a neglected but a critical component of maternal and child health care services [15]. Therefore, in settings where there is low awareness of preconception care, promotion of preconception care among reproductive age group women is important to boost maternal health care services and to reduce complications during antenatal care, institutional delivery and post natal care. However, family planning, utilization, and factors associated with it have not been well understood in resource limiting settings like Ethiopia.

Therefore, the main aim of this study was to describe the level of women’s awareness regarding to preconception care which will help in estimating the preconception care needs of reproductive age group women and which in turn could help to prepare the necessary resources and flourish programs for better reproductive health services. The other main purpose of the current study was addressing the knowledge gap with regard to factors associated with awareness in preconception care among reproductive age group women. Understanding the factors benefit in a way that women as well as care givers intervene on those factors. This study is also believed to benefit many concerned stakeholders in decision making and policy development.

Methods

Setting

This Community based cross sectional study was conducted in Adet town from March 01–30, 2016. Adet Town is an administrative town of Yilmana Densa Wereda and located in West Gojjam Zone, Amhara Regional State. It is located 524 km away from Addis Ababa and 42 km far from Bahirdar. It has an altitude of 2, 216 m above the sea level (Fig. 1).
Fig. 1

Location of Adet town

According to the figures from the Central Statistical Agency in 2015, the estimated total population of the town was 42, 983. Out of this 21, 234 (49.4%) were men and 21, 749 (50.6%) were women. The total number of women who were in reproductive age group (15–49 years) were 14, 248 which accounts 33.1% of the total population [16].

Participants

All women who live in Adet were the source population and all reproductive age group women who live in Adet were the study population. finally, individual reproductive age group women were the stud units. All reproductive age group women who have lived in Adet for 6 months and above were included.

Sampling technique and procedure

A sample size of 422 was determined using single population proportion formula. n = Z2 p (p −1)/d2 with the following assumptions: proportion (P) of a population practicing family planning to be 50% since there was no study conducted in Ethiopia, a confidence level (CI) of 95%, and marginal error (d), 5% and 10% non-response rate.

All the three Kebeles (the smallest unit of the district) of Adet were taken. To reach the study unit systematic sampling technique was used in the Kebeles. The first house was selected randomly in one place and every 32nd house for all kebele was asked. The sampling interval of the households in each Kebele was determined by dividing the total number of households in the specific kebele to the allocated sample size. When there was no a reproductive age group woman in the selected house, nearby house was asked. In case of more than one eligible woman were encountered in the selected household, a lottery method was used to determine which woman would be interviewed.

Variables

The dependent variable was the Knowledge on preconception care, and the independent variables were demographic, socioeconomic characteristics, obstetric history, social behaviour, women’s health status and associated factors.

Operational definition

Preconception care

Any interventions either advice or treatment, and lifestyle modification before being pregnant.

Knowledge

Level of women’s knowledge on preconception care was measured based on correct response using fifteen preconception care knowledge questions and the question was scored out of 34 points. With 50% of cut of point women’s knowledge was divide into two.

Good knowledge

Those who have scored 17–34 of correct responses to preconception care knowledge questions.

Poor knowledge

Those who have scored less than 1–16 correct responses to preconception care knowledge questions.

Smoking status

Had a history of smoking or currently smoke regardless of amount.

Alcohol consumption

Consumption of alcoholic drinks on other than holidays and culturally special ceremony days.

Data collection

Data was collected by three diploma nurse interviewers using a pretested structured questionnaire at working hours’. The questionnaire was translated into local language, Amharic by experts in both languages and was translated back to English by another person to ensure consistency and accuracy. The data collection process was closely supervised by two health officers and the principal investigator. The data collectors and supervisors were recruited based on previous experience on data collection and fluency in the local language. In addition, training was given for two consecutive days on how to interview, handling ethical issues and maintaining confidentiality and privacy. The pre-test study covered 21 reproductive age group women who are living in merawi woreda, which become out of the main study two weeks before the commencement of the main data collection.

Pre-test was conducted to familiarize enumerators with the administration of the interview process and for ensuring consistency. Debriefing sessions were held with the pre-test field staff and the questionnaires were modified based on lessons drawn from the pre-test. Completed questionnaire crosschecked daily for inconsistencies and completeness.

Data analysis

Data was first checked manually for completeness and then coded, entered and cleaned by EPI-Info 3.5.3 statistical software. Then the data were exported to SPSS windows version 20 for data checking, cleaning and logistic regression. Cleaning was done by calculating frequencies and sorting. Bivariate analysis between dependent and independent variables was performed using binary logistic regression. P <0.25 was used as criteria to select candidate variables for multivariate analysis. Multivariable logistic regression analysis was done to adjust for possible confounding variables. P-value <0.05 with 95% confidence interval (CI) for OR (odds ratio) was used in judging the significance of the associations. Results were presented in text, tables and charts.

Ethical consideration

Ethical clearance and approval was obtained from the Ethical review committee of the College of Medicine and Health Science, Mekele University. In addition, the official letter of cooperation granted by the administrative offices of Adet Town. The purpose of the study was explained to the study participants and written informed consent was secured before data collection was started and confidentiality of the information was ensured by coding. Participation was on a voluntary basis after written consent, and responses were kept confidential. The consent procedure was approved by the ethics committee for all. The interview was undertaken privately in separate area.

Results

Socio demographic characteristics

A total of 422 subjects were participated with a response rate of 100%. The median age of the participants was 25 years with an inter quartile range of 11 years. Four hundred twenty one (99.8%) of the participants were Amhara and 358 (84.8%) were Orthodox Christian. Hundred and fourty nine (35.3%) of respondents had a monthly household income of less than or equal to 70 Dollar and 131(31%) were literate. More than half of participants 251 (59.5%) were married and 113(26.8%) of women were housewives. One hundred and twelve (25.4%) and 114(19.8%) of the participant’s husband were market trade vendor and primary school respectively (Table 1).
Table 1

Socio-demographic characteristic of women in Adet, Gojjam, Northwestern Ethiopia, 2016 (n = 422)

Characteristics

Frequency (N)

Percent (%)

Age

 15-24

196

46.4

 25-34

136

32.2

 35-49

90

21.3

Ethnicity

 Amhara

421

99.8

 Shinasha

1

.2

Religion

 Orthodox

358

84.8

 Muslim

60

14.2

 Protestant

4

1.0

Occupation

 Housewife

113

26.8

 Market trade vendor

107

25.4

 Civil servant

79

18.7

 Student

95

22.5

 Daily laborer

28

6.6

Educational status

 No formal education

99

23.5

 Primary school

97

23.0

 Secondary school

131

31.0

College and above

95

22.5

Monthly income

  ≤ 70 Dollar

149

35.3

 70.5-117.5 Dollar

96

22.7

 118-177.5 Dollar

55

13.1

 178-250 Dollar

65

15.4

  > 250

57

13.5

Marital status

 Married

251

59.5

 Divorced

35

8.3

 Widowed

17

4.0

 Single

119

28.2

Husband’s educational status (n = 251)

 No formal education

47

18.7

 Primary school

112

44.6

 Secondary school

54

21.5

 College and above

38

15.2

Husband’s occupation (n = 251)

 Market trade vendor

114

45.4

 Governmental employee

84

33.5

 Daily laborer

37

14.7

 Farmer

16

6.4

Communication

 Mobile

287

68.0

 Television

199

47.2

 Radio

92

21.8

 None

65

15.4

NB. For communication the total summation of percentage is more than 100% due to multiple answers

Table 2

Women’s knowledge on general concept of preconception care in Adet, West Gojjam, North Western, Ethiopia, 2016 (n = 422)

Variables

Frequency (N)

Percentage (%)

Ever heard

 Yes

134

31.8

 No

288

68.2

Preconception care needed

 For men, only

6

1.4

 For women, only

18

4.3

 For men and women

60

14.2

 Don’t know

338

80.1

Preconception care important

 For baby, only

22

5.2

 For mother, only

39

9.2

 For baby and mother

70

16.6

 Don’t know

291

69.0

Site for preconception care

 Home

5

1.2

 Health institution

73

17.3

 Home and health institution

56

13.3

 Don’t know

288

68.2

 Total

422

100

Obstetrics characteristics

Two hundred sixty eight (63.5%) has been pregnant before. Of the 268, 168 (62.7%) of them had ≤ 2 alive children and 100 (37.3%) of them had 3 or more alive children. One hundred and fifty four (36.4%), 53(12.6%), 191 (45.3%) and 24 (5.7%) of participants were nulliparous, primi para, multipara and grand multiparous respectively. The majority (58.1%) of respondents had a history of family planning use (Fig. 2). From 5 women who had history of congenital anomaly baby, two of them were counseled for subsequent pregnancy.
Fig. 2

Obstetrics characteristics of women in Adet, West Gojjam, Northwestern Ethiopia, 2016 (n = 422)

Health status and social behaviour of women

Thirty-five (8.3%) of respondents had a chronic health problem and from those who had chronic health problem 7 (20%) of them were known HIV positive women (Fig. 3). Four hundred twenty one (99.8%) of participants were not cigarette smoker and only 1 woman (0.2%) was addicted to alcohol.
Fig. 3

Types of chronic health problem women have in Adet, west Gojjam, North Western Ethiopia, 2016 (n = 35)

Preconception care knowledge score

Among the total of 422 participants, 134 (31.8%) of women have heard about preconception care before. For those who have heard about preconception care; the major source of information was health institution 69 (51.5%) and minority 9 (6.7%) of them have heard from friends. Fourty (29.8%), 32 (23.9%) and 14 (10.5%) of them have heard from the mass media, school and family/relatives respectively (Table 2).

The minimum and maximum score of participants was 1 and 34 respectively. One hundred and sixteen (27.5%) (95% CI: 23.2, 32.0) of them had good knowledge on preconception care (Table 3).
Table 3

Women’s knowledge on preconception health and behavioural risk factors on fetus in Adet, West Gojjam, North Western, Ethiopia, 2016 (n = 422)

Variables

Frequency (N)

Percentage (%)

Diabetes mellitus

 Yes

88

20.9

 No

334

79.1

Epilepsy

 Yes

83

19.7

 No

339

81.3

Obesity

 Yes

87

20.6

 No

335

79.4

STIs and HIV/AIDS

 Yes

138

30.3

 No

284

69.7

Heart disease, including hypertension

 Yes

87

20.6

 No

335

79.4

Stress and depression

 Yes

78

18.5

 No

344

81.5

Genetic problem

 Yes

55

13.0

 No

367

87.0

Cigarette smoking

 Yes

141

33.4

 No

281

66.6

Alcohol consumption

 Yes

143

33.9

 No

279

66.1

Exposure to environmental hazard

 Yes

72

17.1

 No

350

82.9

Illegal drug intake

 Yes

99

23.5

 No

323

76.5

Gender based violence, including FGM

 Yes

66

15.6

 No

356

84.4

Table 4

Women’s knowledge on preconception care component in Adet, West Gojjam, Northwestern Ethiopia, 2016 (n = 422)

Variables

Frequency(N)

Percentage (%)

Take folic acid

 Yes

66

15.6

 No

356

84.4

Weight should be maintained

 Yes

123

29.1

 No

299

70.9

Modify diet

 Yes

113

26.9

 No

309

73.1

Regular exercise

 Yes

80

19.9

 No

342

80.1

Substance should be avoided

 Yes

133

31.5

 No

289

68.5

Avoid cigarette smoking

 Yes

127

30.1

 No

295

69.9

Avoid alcohol consumption

 Yes

119

28.2

 No

303

71.8

Avoid illicit drugs

 Yes

101

23.9

 No

321

76.1

Create healthy environment

 Yes

123

29.1

 No

299

70.9

Free from environmental radiation

 Yes

103

24.4

 No

319

75.6

Free from environmental chemical

 Yes

100

23.7

 No

322

76.3

Free from stressors

 Yes

106

25.1

 No

316

74.9

 Total

422

100.

Knowledge on preconception health and behavioural risk factors on fetus

Regarding women’s knowledge on preconception health and behavioural risk factors; alcohol consumption (33.9%), cigarette smoking (33.4%) and STIs including HIV/AIDS are most frequently mentioned issues, whereas gender based violence (15.6%), and genetic problem (13%), were the least frequently mentioned issues (Table 5).
Table 5

Association between different variables and women’s level of knowledge on preconception care in Adet, West Gojjam, North western Ethiopia, 2016(n = 422)

Variables

Level of knowledge

COR (95%CI)

AOR (95%CI)

 

Poor (%)

Good (%)

 

Age

 15–24

165(84.2)

31(15.8)

1

1

 25–34

86(63.2)

50(36.8)

3.10(1.84 -5.20)**

2.38 (1.14-4.95) **

 35–49

55(61.1)

35(38.9)

3.39(1.91- 6.00)**

4.10 (1.78-9.44) **

Educational status

 No formal education

86(86.9)

13(13.1)

1

1

 Primary school

72(73.4)

25(25.8)

2.30(1.10-4.81)**

3.37 (1.35-8.42) **

 Secondary school

95(72.5)

36(27.5)

2.51 (1.25-5.04)**

3.85 (1.54-9.56) **

 College and above

53(55.8)

42(44.2)

5.24 (2.58-10.63)**

6.52 (2.55-16.69) **

History of family planning use

 Yes

155(63.3)

90(46.7)

1

1

 No

151(85.3)

26(14.7)

0.30(0.18-0.48)**

0.15(0.045-0.44) **

NB: **indicates p-value <0.05, CI = confidence Interval

Knowledge on changes should be made before pregnancy

Based on women’s knowledge on what things should be made before pregnancy: pregnancy should be planned were mentioned by 100% of women, visit health institution (31.8%), and screened and treated for disease (31.8%) before pregnancy were the most frequently listed, whereas get a vaccination (14.6%) and family palming use (11.8%) were the least frequently listed issues (Table 4).

Predictors of knowledge for preconception care

Results of binary logistic regression showed that Women whose age is more than 25 years, who are civil servants, who attended more than primary education, whose monthly income is between 118 and 177.5 Dollar, whose husband attended college and above, whose husband is civil servant, were identified as significant predictors of knowledge for preconception care while Women who had no history of family planning use were not associated.

In multivariable logistic regression three variables, i.e., women’s age, history of family planning and educational status were associated. When compared with those who are not able to write and read, women who attended more primary education were more than three times more likely to know preconception care (AOR: 3.37; 95% CI: 1.35, 8.42). In addition, women whose age is above 25 years were 2.38 times more likely to know preconception care than their counterparts (AOR: 2.38; 95% CI: 1.14, 4.95).

However, women who had no history of family planning use were 85% less likely to know preconception care than women who had a history of family planning use (AOR: 0.15; 95% CI: 0.05, 0.44) (Table 5).

Discussion

The study revealed that overall knowledge of preconception care by reproductive age group women was 27.5%, which was higher than studies carried out in Sudan (11.1%) [11], Iran (10.4%) and Nepal (15.6%) [17, 18]. The highest knowledge in this study might be due to the fact that there were varied in time and large and representative sample size, which make the study comprehensive. However, it is significantly lower than the findings from Saudi Arabia (37.9%), Jordan (85%) [19, 20], Egyptian (76%) and Arabian (51%) mothers [21]. The low knowledge level in this study might be due to the relative low media coverage in Ethiopia, which showed there is a need to broaden media coverage in the country. In addition, it is lower than a study conducted in the USA among low income Mexican American group (76%) [12]. This might be due to the fact that the study population in the USA was women who presented in women’s care clinic and most of the participants had higher levels of educational status. Whereas, this study was community based and most women were not educated. It may be also due to the absence of strategies and policies of the Ethiopian Ministry of Health regarding addressing Preconception care.

In the study, measure factors that influenced knowledge of preconception care were education, age, and history of family planning use.

It was observed that women who attended primary education were more than three times more knowledgeable than women who had no formal education (AOR: 3.37; 95% CI: 1.35, 8.42). The finding of this study is not consistent with studies conducted in Nigeria and Sudan [11, 22]. This might be due to the difference in study population and large sample size in our study. Similarly, women who had secondary school education were four times more likely knowledgeable than women who had no formal education (AOR: 3.85; 95% CI: 1.54, 9.56). The finding of this study is consistent with a study done in Iran [23], Nigeria and Sudan [11, 22]. This might be due to the fact that when the women’s educational level is increasing, there might be exposed to information regarding to preconception care. The more educated women may be motivated to know about health and risk factors and they might have interest to read, listen and watch any information sources.

In addition, women who attended college and above education were nearly seven times more likely had better knowledge than those who had no formal education (AOR: 6.52; 95% CI: 2.55, 16.69), which was in line with the findings reported from the Netherlands, USA and Nigeria [2426], Iran, Sri Lanka, and USA, where the women’s level of awareness of preconception care was increased with their educational status [8, 12, 17]. However, this finding is not consistent with studies done in Jordan, Nepal and Ghana [18, 20, 27]. This might be due to the fact that education improves communication with partner, women’s status in the community and the influence of education on women’s decision making skill to search source of information.

Similarly, women whose age is from 25 to 34 years were more than two times more knowledgeable than those whose age is from 15 to 24 years (AOR: 2.38; 95% CI: 1.14, 4.95). This is in line with a finding from USA [24]. This might be explained by women who are in these age groups are mostly at high risk to be pregnant and give birth and seek information about preconception health and social behaviour risk factors and other things related to preconception care.

On the other hand, women who were in the age group of 35–49 years were 4 times more likely had better knowledge about preconception care than those who were in the age group of 15–24 years (AOR: 4.10; 95% CI: 1.78, 9.44). The result of this study is consistent with studies conducted in the Netherlands, Italy, Nigeria [26, 28, 29], China, Iran and USA [12, 17, 30]. This might be due to the fact that women’s knowledge on preconception care was increased with their age. However; this finding is not consistent with studies conducted in Jordan, Nepal [18, 20], Nigeria, Ghana and Sudan [11, 22, 27]. This might be due to the fact that our study was community based, conducted in large sample size and the study population were rural women who relatively have no access of information, which showed that there is a need to settle a strategy to address this issue.

Finally, this study noted that women who had no history of family planning use were 85% less knowledgeable than those who had a history of family planning use (AOR: 0.15; 95% CI: 0.05,0.44). This finding is in line with studies conducted in China, France, and Sudan as all of the studies showed that use of contraception was positively associated with women’s knowledge in preconception care [11, 31, 32]. This might be due to the fact that pregnancy counselling, including preconception care is being given in the family planning unit, women who used family planning might have information regarding preconception care. However, the finding of this study is not consistent with a study conducted in Francisco general hospital [33]. This might be due to relative large sample size and community based study design of our study, which makes our study sounding. In addition, this might be due to the access of information in the Francisco general hospital about their contraceptive use, but Ethiopian women may need to visit health institutions as it was the major source of information.

However, this study does have some inherent limitations. First, the study design makes it difficult to determine the direction of causality and there is a risk of social desirability bias and interviewer bias. In addition, this study was not triangulated which might be difficult to get new factors, and suggested to be studied in the future. Finally, though there are wide ranges of factors which affect knowledge of preconception care among reproductive age group women, only individual level factors were addressed in this study. Hence, considering factors from the service providers’ side and structural barriers would have been important.

Conclusions

The finding of this study showed that women’s knowledge on preconception care is low. This finding revealed that only a woman’s age, educational status, and history of family planning use were statically associated with women’s knowledge in preconception care. It indicated that being elder, having a high educational level, and having a history of family planning use were increased women’s level of knowledge of preconception care. Therefore, establishing preconception care strategies which can address all the components of the care and advocating women’s education and family planning use are important.

Abbreviations

AOR: 

Adjusted odds ratio

HIV: 

Human immune deficiency virus

NTDs: 

Neural tube defects

PCC: 

Preconception care

USA: 

United states of america

Declarations

Acknowledgements

We are very grateful to Mekele University for the approval of the Ethical Clearance, and Debretabor University for its financial support to the study. We express our heartfelt thanks to participants for their willingness to participate in the study, without whom this research would be impossible.

Funding

The authors have no support or funding to report.

Availability of data and material

The datasets generated during the current study are available from the corresponding author on reasonable request.

Authors’ contributions

YA Contributed in inception, design, analysis, interpretation, drafting of a research manuscript and final approval of the revised manuscript for publication. AM Contributed in inception, design, analysis, interpretation, drafting the research manuscript and final approval of the revised manuscript for publication. MD Contributed in inception, design, analysis, interpretation, drafting of a research manuscript and final approval of the revised manuscript for publication. AS Contributed in inception, design, analysis, interpretation, drafting of a research manuscript and final approval of the revised manuscript for publication. All authors read and approved the final manuscript.

Competing interests

We, the authors declare that we didn’t have competing interests.

Consent for publication

Consent for publication is available and can be send to the editors on request.

Ethics approval and consent to participate

This study was approved by Mekele University, College Health Sciences, Department of Midwifery Health ethics committee, and informed verbal consent was obtained from all study subjects.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Department of midwifery, College of Health Sciences, University of Debre Tabor
(2)
Department of Midwifery, College of Health Sciences Mekelle University

References

  1. World Health Organization: preconception health; maximizing the gains of maternal and child health. World Health Organization 2013. Accessed at www.who.int/maternal-child-adolescent//document/concensus-preconception-care/en/.
  2. Dean S, et al. Setting research priorities for preconception care in low-and middle-income countries: aiming to reduce maternal and child mortality and morbidity. PLoS Med. 10(9):e1001508.Google Scholar
  3. DeWeger FJ, et al. Advanced maternal age, short inter-pregnancy interval, and perinatal outcome. Am J Obstet Gynecol. 2011;24(5):(421):9.Google Scholar
  4. Hood JR, Parker C, Atrash HK. Recommendations to improve preconception health and health care. 2007;16(4):454–7.Google Scholar
  5. World Health Organization. Meeting to develop a global consensus on preconception care to reduce maternal and childhood mortality and morbidity. Geneva: World Health Organization; 2013.Google Scholar
  6. Mason E, et al. Preconception care; advancing from important to do and can be done to is being done and is making a difference, in low income countries. Reprod Health. 2014;11(3):8.View ArticleGoogle Scholar
  7. American College of Obstetricians and Gynecologists: The Importance of Preconception Care in the Continuum of Women's Health Care. committee opinion No 313. Obstet Gnecol. 2005;106(3):665–6.Google Scholar
  8. Patabendige M, Goonewardene IM. Preconception care received by women attending antenatal clinics at a Teaching Hospital in Southern Sri Lanka. Sri Lanka J Obstet Gynaecol. 2013;35(1).Google Scholar
  9. Idris SH, Sambo MN, Ibrahim MS. barriers to utilization of maternal health service in a semi urban community in Norther Nigeria. Niger Med J. 2013;54(1):6.View ArticleGoogle Scholar
  10. Olayinka OA, et al. Awareness and barriers to utilization of maternal health care services among reproductive women in Amassoma community, Bayelsa State. Int J Nurs Midwifery. 2014;6(1):6.Google Scholar
  11. Ahmed KM, et al. Knowledge, attitude and practice of preconception care among Sudanese women in reproductive age about rheumatic heart disease at Alshaab and Ahmad Gassim hospitals 20142015 in Sudan. Basic Res J Med Clin Sci. 2015;4(7):5.Google Scholar
  12. Coonrod DV, et al. Knowledge and attitudes regarding preconception care in a predominantly low-income Mexican American population. Am J Obstet Gynecol. 2009;200(6):(676):7.View ArticleGoogle Scholar
  13. Oklahoma Pregnancy Risk Assessment Monitoring System. Preconception care among Oklahoma women. Maternal Child Health Serv. 2008;12(1):6.Google Scholar
  14. World Health Organization: preconception health. Regional expert group consultation on preconception care, in newdelhi. India: World Health Organization; 2013.Google Scholar
  15. LU MC, Geffen D. Recommendations for preconception care. Am Fam Physician. 2007;76(3):4.Google Scholar
  16. Central Statistical Agency, Addis Ababa. National Survey. Central Statistical Agency 2015.Google Scholar
  17. Ghaffari F, et al. Application of Donabedian Quality-of-Care Framework to Assess the Outcomes of Preconception Care in Urban Health Centers, Mashhad, Iran in 2012. J Midwifery Reprod Health 2013;2(1):50–9.Google Scholar
  18. Gautan P, Dhakal R. Knowledge on preconception care among reproductive age women. Saudi J Med Pharm Sci. 2016;2(1):6.Google Scholar
  19. Madanat AY, Sheshah EA. Preconception care in Saudi women with diabetes mellitus. J Fam Community Med. 2016;23(2):6.View ArticleGoogle Scholar
  20. Al-Akour NA, et al. Awareness of preconception care among women and men: a study from Jordan. J Obstet Gynaecol. 2015;35:5.View ArticleGoogle Scholar
  21. Mohammed AR, Mohammed SA, Abdulfatah AM. Congenital Anomalies among Children: Knowledge and Attitude of Egyptian and Saudi Mothers. Biol Agric Healthcare. 2013;3:2224–3208.Google Scholar
  22. Ezegwui HU, et al. Preconception care in South Eastern Nigeria. Obstet Gynaecol. 2008;28(8):4.Google Scholar
  23. Masoumeh P, et al. Knowledge of pregnant women about congenital anomalies: A cross‑sectional study in north of Iran. Indian J Health Sci. 2015;8(1):41.Google Scholar
  24. De Rosset L, Mullenix A, Zhang A. Multivitamins, Folic Acid and Birth Defects: Knowledge, Beliefs and Behaviors of Hispanic women in North Carolina. Am J Health Educ. 2009;40(3):155–64.Google Scholar
  25. Lawal TA, Yusuf OB, Fatiregun AA. Knowledge of birth defects among nursing mothers in a developing country. Afr Health Sci. 2015;15(1):180–7.Google Scholar
  26. Temel S, et al. Knowledge on preconceptional folic acid supplementation and intention to seek for preconception care among men and women in an urban city: a population based cross-sectional study. BMC Pregnancy Childbirth. 2015;15(1):1.Google Scholar
  27. Bello AI, et al. Knowledge of pregnant women about birth defects. BMC Pregnancy Childbirth. 2013;13(1):1.Google Scholar
  28. Esposito G, et al. Women’s Knowledge, Attitudes and Behavior about Maternal Risk Factors in Pregnancy. PLoS ONE 2015;10(12) e0145873.Google Scholar
  29. Anzaku AS. Assessing folic acid awareness and its usage for the prevention of neural tube defects among pregnant women in Jos, Nigeria. J Basic Clin Reprod Sci. 2013;2(1):3.View ArticleGoogle Scholar
  30. Min-xia D, Hai-yang Z, Chang-qiang Z. Awareness Status of Preconception Health Care among Rural Women of Child-Bearing Age and Its Determinants. Chinese Gen Pract. 2011;32:037.Google Scholar
  31. Brunet C, et al. Knowledge about preconception care in French women with type 1 diabetes. Diabetes Metabism. 2005;31(5):443–7.Google Scholar
  32. Minxia D, et al. Investigation on the Present Situation and Factors Influencing Rural cognitive preconception care. Chin Acad J 2011; 32.Google Scholar
  33. Mittal P, Dandekar A, Hessler D. Use of a modified reproductive life plan to improve awareness of preconception health in women with chronic disease. Perm J. 2014;18(2):5.View ArticleGoogle Scholar

Copyright

© The Author(s). 2017