Preconception Care in Low- and Middle-Income Countries

Abstract

Prior to pregnancy, the preconception period is pertinent to optimising the health of women and their partners in respect to biomedical, behavioural, and social factors to reduce their impact on maternal, neonatal, and child health outcomes. In Low and Middle-Income Countries (LMICs), this is particularly crucial where women and girls are most vulnerable to these risk factors that lead to adverse pregnancy outcomes. With the rising importance of preconception care in LMICs, this review summarises current evidence on direct and indirect intervention approaches to preconception spanning biomedical, behavioural, and social factors. Direct intervention approaches focus on health issues such as infections, chronic disease, mental health, and substance abuse, whilst indirect interventions address social factors, such as gender inequality, that influence preconception health and accessing care. Despite this, significant gaps remain to be addressed for preconception care in LMICs, particularly for male preconception care and involvement of male partners in reproductive/preconception health and mental health interventions for reproductive-aged women. To strengthen the delivery of preconception care in LMICs, sustainable and collective efforts by all relevant stakeholders are important to ensure preconception care interventions are not fragmented and the most vulnerable women are reached.