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Effect of Preconception Lifestyle Counselling on Healthy Lifestyle Practices among Women Planning Pregnancy in Nigeria

Abstract

Healthy lifestyle practices before conception are important components of preconception care because women's nutritional, physical, behavioural, and general health status may influence fertility, pregnancy, maternal health, and fetal development. Unhealthy lifestyle practices such as physical inactivity, poor dietary habits, tobacco use, harmful alcohol consumption, inadequate sleep, and excessive stress may contribute to adverse health outcomes before and during pregnancy. Despite the importance of preconception health, many women planning pregnancy in Nigeria may have limited access to individualized lifestyle counselling and may not receive adequate guidance on healthy behaviours before conception. Preconception lifestyle counselling provides an opportunity for healthcare professionals to educate women about healthy nutrition, physical activity, weight management, avoidance of tobacco and harmful alcohol use, adequate sleep, stress management, and other appropriate health-promoting behaviours. Against this background, this study investigates the effect of preconception lifestyle counselling on healthy lifestyle practices among women planning pregnancy in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Promotion Model. The Health Belief Model explains how women's perceptions of health risks, perceived benefits of healthy lifestyle practices, perceived barriers, and cues to action may influence their adoption of healthier behaviours before pregnancy. Social Cognitive Theory emphasizes knowledge, self-efficacy, behavioural capability, observational learning, social support, and environmental influences in the development and maintenance of healthy lifestyle practices. The Health Promotion Model emphasizes individual experiences, perceived benefits and barriers, interpersonal influences, and behavioural factors that influence participation in health-promoting activities. Collectively, these theoretical perspectives provide a suitable framework for explaining how preconception lifestyle counselling may influence healthy lifestyle practices among women planning pregnancy in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise women of reproductive age who are planning pregnancy and attending selected primary healthcare centres, hospitals, family planning clinics, preconception care clinics, and community health programmes across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, clinics, and eligible women. Preconception lifestyle counselling will be assessed using indicators such as exposure to counselling, frequency and duration of counselling sessions, individualized health assessment, dietary counselling, physical activity guidance, weight-management advice, tobacco and alcohol avoidance education, sleep guidance, stress-management education, healthcare-provider follow-up, educational materials, and referral to appropriate support services. Healthy lifestyle practices will be assessed using indicators such as consumption of balanced and diverse diets, regular physical activity, maintenance of a healthy body weight, avoidance of tobacco products, avoidance or appropriate management of alcohol use, adequate sleep, stress-management practices, and attendance at recommended preventive healthcare services. Data will be collected using structured questionnaires and appropriate validated lifestyle assessment tools, together with relevant preconception clinic records and health education programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to lifestyle counselling, and patterns of healthy lifestyle practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of preconception lifestyle counselling on healthy lifestyle practices. Where a quasi-experimental design is adopted, lifestyle practice scores before and after exposure to structured counselling may be compared, while relevant demographic, socioeconomic, reproductive, and healthcare-access factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that preconception lifestyle counselling has a significant positive effect on healthy lifestyle practices among women planning pregnancy in Nigeria. Women who receive structured and individualized lifestyle counselling are expected to demonstrate better dietary practices, increased physical activity, improved health behaviours, and greater avoidance of harmful lifestyle practices than women with limited exposure to preconception counselling. Counselling may improve women's knowledge of the relationship between lifestyle and reproductive health while increasing confidence in adopting and maintaining healthier behaviours. Repeated counselling and follow-up through preconception and primary healthcare services may further reinforce healthy lifestyle practices before conception. However, financial constraints, food insecurity, limited recreational facilities, cultural practices, workload, environmental barriers, low health literacy, and limited access to continuous counselling may reduce the effectiveness of lifestyle education alone. The study therefore expects accessible, individualized, culturally appropriate, and continuous preconception lifestyle counselling to contribute significantly to improved healthy lifestyle practices among women planning pregnancy in Nigeria. The study is expected to contribute to the literature on preconception lifestyle counselling, healthy lifestyle practices, preconception care, reproductive health, maternal health, nutrition, physical activity, health promotion, 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, hospitals, primary healthcare centres, family planning clinics, healthcare professionals, maternal health programmes, nutrition programmes, development partners, and policymakers regarding strategies for strengthening preconception health promotion. The study will also provide evidence-based recommendations for integrating comprehensive lifestyle counselling into routine preconception and reproductive health services, training healthcare providers in lifestyle counselling, developing culturally appropriate educational materials, strengthening follow-up and behavioural support, and improving access to community-based health promotion services for women planning pregnancy across Nigeria.

Keywords: Preconception lifestyle counselling, healthy lifestyle practices, women planning pregnancy, preconception care, health promotion, healthy diet, physical activity, reproductive health, maternal health, Nigeria, public health.