Understanding community perceptions, preparedness, and expectations of preconception care: A formative research approach

Abstract

Background: Addressing preconception health through targeted interventions, as advocated by the WHO, can greatly improve maternal and child outcomes. Objectives: The study explores community perceptions, preparedness, and expectations regarding preconception care (PCC). It evaluates the acceptance of nurses delivering PCC services, the efficiency of a community-based PCC package, and community readiness for village-level PCC services, aiming to co-develop a tailored PCC package. Design and methods: This formative research, conducted from March to September 2024, used a qualitative approach comprising focus group discussions, in-depth interviews, and free listing with ranking exercises across 96 villages under four primary health centers (PHCs) in rural Maharashtra, India with population of around 120,000, was carried out across four PHCs: PHC An (28 villages), PHC Kh (G) (25 villages), PHC Ta (Wa) (25 villages), and PHC Wa (26 villages). The study involved diverse participants, including eligible couples, village representatives, and community health workers. Data were analyzed using thematic content analysis, employing both deductive and inductive methods to identify themes related to perceptions, contributions, and expectations for PCC. Results: The study revealed limited community awareness of PCC, especially regarding genetic screening and early detection. Despite this, participants recognized PCC’s benefits for maternal health and safer deliveries, strongly supporting locally accessible clinics. Community priorities such as health screening, family well-being, and lifestyle changes reflected a holistic view of PCC. Communities proposed low-cost services, local clinic management, and promotion via self-help groups and village platforms. Expectations included diagnostics, infertility treatment, nutrition support, and counseling, with calls for both doctors and nurses to deliver services effectively. Conclusion: The findings highlight the community’s readiness to adopt PCC services, provided they are affordable, accessible, and tailored to local needs. The study underscores the importance of culturally sensitive approaches and leveraging community networks to promote PCC. Integrating locally prioritized areas into PCC frameworks can enhance maternal and child health outcomes and ensure effective implementation in resource-limited settings.