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

Abstract

Preconception health is an important component of maternal and reproductive healthcare because health conditions and behaviours before pregnancy can significantly influence pregnancy outcomes and the health of mothers and newborns. Women of reproductive age may have existing medical conditions, nutritional deficiencies, infections, unhealthy lifestyle practices, or reproductive health concerns that can affect future pregnancies if not identified and appropriately managed before conception. Preconception health services provide an opportunity to assess women's health status, identify and manage risk factors, provide health education and counselling, promote healthy behaviours, offer appropriate screening and preventive interventions, and support pregnancy planning. Despite the potential benefits of preconception care, utilization remains limited in many settings in Nigeria due to inadequate awareness, limited availability of services, financial barriers, geographical inaccessibility, cultural factors, and insufficient integration of preconception services into routine healthcare. Preconception care utilization refers to the extent to which women of reproductive age access and use appropriate healthcare services before becoming pregnant. Against this background, this study investigates the effect of preconception health services on preconception care utilization 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 preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action and provides a framework for understanding women's willingness to utilize preconception services. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need-related factors and provides a framework for examining the use of preconception care services. The Health Systems Framework emphasizes service delivery, health workforce, health information, essential medicines and technologies, financing, and accessibility as important components of effective healthcare delivery. Collectively, these theoretical perspectives provide a suitable framework for explaining how the availability and accessibility of preconception health services may influence preconception care utilization among women in Nigeria. The study will adopt a quantitative cross-sectional or analytical research design. The study population will comprise women of reproductive age, generally 15–49 years, residing in selected communities and accessing healthcare services in Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible participants. Preconception health services will be assessed using indicators such as availability of preconception counselling, reproductive health assessment, screening for chronic diseases and infections, nutritional assessment, folic acid counselling or supplementation, vaccination services, family planning and fertility counselling, medication review, lifestyle counselling, health education, and availability of trained healthcare providers. Preconception care utilization will be assessed using indicators such as attendance at preconception consultations, frequency of preconception visits, uptake of recommended screening services, receipt of counselling, use of preventive interventions, and completion of recommended preconception care activities before pregnancy. Data will be collected using structured questionnaires, healthcare facility records, service registers, and relevant programme documents where available. Descriptive statistics will be used to summarize participants' characteristics, availability of preconception services, and utilization patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be used to determine the effect of preconception health services on preconception care utilization. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that the availability and accessibility of comprehensive preconception health services have a significant positive effect on preconception care utilization among women of reproductive age in Nigeria. Women who have access to affordable, accessible, and comprehensive preconception services are expected to be more likely to utilize recommended preconception care than women with limited access to such services. Availability of counselling, health screening, nutritional services, reproductive health assessment, and preventive interventions may increase women's awareness of pregnancy-related health risks and encourage appropriate health-seeking behaviour before conception. Integration of preconception services into primary healthcare and reproductive health programmes may further improve access and reduce missed opportunities for preventive care. Conversely, limited service availability, inadequate numbers of trained healthcare providers, financial barriers, geographical distance, long waiting times, insufficient health information, and limited awareness may reduce utilization. However, preconception care utilization may also be influenced by women's educational status, socioeconomic circumstances, reproductive intentions, cultural beliefs, previous healthcare experiences, and perceptions of the need for preconception services. The study is expected to contribute to the literature on preconception health services, preconception care utilization, reproductive health, maternal health, preventive healthcare, women's health, primary healthcare, epidemiology, 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, reproductive and maternal health programme managers, primary healthcare facilities, healthcare professionals, community health workers, development partners, and policymakers regarding strategies for improving preconception care utilization. The study will also provide evidence-based recommendations for expanding preconception health services, integrating preconception care into routine reproductive and primary healthcare, increasing public awareness, strengthening healthcare-worker training, improving access to screening and preventive services, reducing financial and geographical barriers, and developing appropriate health education strategies to encourage women of reproductive age to seek preconception care before pregnancy across Nigeria.

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