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Effect of Preconception Care Services on Preconception Health Screening among Women of Reproductive Age in Nigeria

Abstract

Preconception health remains an important component of maternal and reproductive healthcare because the health status of women before pregnancy can influence pregnancy outcomes, maternal health, fetal development, and the risk of pregnancy-related complications. In Nigeria, many women of reproductive age enter pregnancy without adequate assessment of existing health conditions, nutritional status, immunization needs, infectious diseases, reproductive health problems, and other factors that may affect pregnancy. Preconception care services provide an opportunity to identify and address health risks before conception through health education, medical assessment, nutritional counselling, screening, immunization, medication review, and appropriate referral. Preconception health screening may facilitate early identification of conditions such as hypertension, diabetes, anaemia, sexually transmitted infections, HIV, hepatitis, obesity, and other health problems requiring intervention before pregnancy occurs. However, utilization of preconception care services remains limited in many settings because of inadequate awareness, limited availability of services, financial barriers, sociocultural factors, limited integration of preconception care into primary healthcare, and inadequate access to reproductive health services. Against this background, this study investigates the effect of preconception care services on preconception health screening among women of reproductive age in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Health Systems Framework. The Health Belief Model explains how women's perceptions of susceptibility to health problems, perceived severity, perceived benefits of preconception care, perceived barriers, and cues to action may influence their use of preconception health services and screening. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need-related factors and provides a framework for understanding women's use of preconception healthcare services. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as important components of effective healthcare delivery. Collectively, these theoretical perspectives provide a suitable framework for explaining how preconception care services may influence preconception health screening among women of reproductive age in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise women of reproductive age, generally aged 15–49 years, in selected communities and healthcare facilities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible women. Preconception care services will be measured using indicators such as availability of preconception counselling, health education, nutritional assessment, medical history review, reproductive health assessment, medication review, immunization services, risk assessment, referral services, and access to trained healthcare providers. Preconception health screening will be assessed using indicators such as screening for hypertension, diabetes, anaemia, HIV, sexually transmitted infections, hepatitis, nutritional deficiencies, obesity, reproductive health conditions, and other relevant health risks before pregnancy. Data will be collected using structured questionnaires, healthcare facility records, screening registers, service utilization records, and relevant programme documents. Descriptive statistics will be used to summarize women's characteristics, utilization of preconception care services, and patterns of preconception health screening. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of preconception care services on preconception health screening. Where appropriate, screening uptake before and after exposure to preconception care services may be compared to determine changes associated with the services. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that preconception care services have a significant positive effect on preconception health screening among women of reproductive age in Nigeria. Women who have access to comprehensive preconception care services are expected to demonstrate higher uptake of recommended health screening than women with limited or no access to such services. Preconception counselling and health education may improve women's awareness of the importance of identifying health conditions before pregnancy and encourage them to seek appropriate screening. Regular provision of preconception services may also improve early identification of conditions such as hypertension, diabetes, anaemia, HIV, sexually transmitted infections, and other health risks, allowing timely treatment, referral, and preventive interventions before conception. Conversely, inadequate availability of services, poor awareness, financial barriers, limited healthcare access, and insufficient integration of preconception care into routine reproductive healthcare may reduce screening uptake. The study therefore expects comprehensive and accessible preconception care services to contribute significantly to improved preconception health screening among women of reproductive age in Nigeria. The study is expected to contribute to the literature on preconception care, preconception health screening, reproductive health, maternal health, preventive healthcare, women's health, primary healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, reproductive health programme managers, healthcare providers, development partners, women's health organizations, and policymakers regarding strategies for strengthening preconception healthcare. The study will also provide evidence-based recommendations for integrating preconception care into routine reproductive and primary healthcare services, improving awareness among women of reproductive age, expanding access to preconception screening, strengthening healthcare worker training, improving availability of screening equipment and essential services, reducing financial and geographical barriers, and establishing effective referral and follow-up systems to improve preconception health screening across Nigeria.

Keywords: Preconception care services, preconception health screening, women of reproductive age, reproductive health, maternal health, preventive healthcare, primary healthcare, health screening, Nigeria, women's health, preconception health, public health.