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Effect of Health Education on Knowledge of Preconception Care among Women of Reproductive Age in Nigeria

Abstract

Preconception care is an important component of reproductive, maternal, and child health and provides an opportunity to identify and address health, behavioural, nutritional, and social factors that may affect pregnancy and maternal and fetal outcomes. Women of reproductive age in Nigeria may have limited knowledge of preconception care because of inadequate health information, misconceptions about pregnancy preparation, limited access to reproductive health services, cultural beliefs, financial barriers, and the perception that healthcare is only necessary after conception. Limited knowledge may reduce women's ability to seek appropriate care, address existing health conditions, improve nutritional status, take recommended supplements, update vaccinations, avoid harmful substances, and adopt healthy behaviours before pregnancy. Health education provides an opportunity to improve women's understanding of preconception care and encourage appropriate preparation for healthy pregnancy. Against this background, this study investigates the effect of health education on knowledge of preconception care among women of reproductive age in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Framework, and Social Ecological Model. The Health Belief Model explains how women's perceptions of susceptibility to pregnancy-related health problems, perceived severity, perceived benefits of preconception care, perceived barriers, self-efficacy, and cues to action may influence their knowledge and health-seeking decisions. The Health Literacy Framework emphasizes women's ability to access, understand, evaluate, and apply health information related to preparing for pregnancy. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, healthcare, cultural, and socioeconomic factors on access to and utilization of preconception services. Collectively, these theoretical perspectives provide a suitable framework for explaining how health education may influence knowledge of preconception care among women of reproductive age in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women aged 15–49 years residing in selected urban and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, healthcare facilities, and eligible women. Health education will be assessed using indicators such as exposure to preconception-care education, frequency and duration of educational sessions, information on healthy pregnancy preparation, medical history and risk assessment, screening for chronic health conditions, reproductive health assessment, nutritional counselling, folic acid supplementation, immunization, infection prevention, medication review, avoidance of tobacco and harmful alcohol use, healthy weight, physical activity, mental health, genetic and family history, sexually transmitted infection prevention, oral health, birth spacing, and appropriate healthcare-seeking before pregnancy. Knowledge of preconception care will be assessed using indicators such as women's ability to define preconception care, identify its purpose, recognize appropriate timing for seeking preconception services, identify important health assessments before pregnancy, understand the importance of folic acid and appropriate nutrition, recognize the role of vaccination and infection prevention, understand the importance of managing existing health conditions, identify harmful behaviours and substances to avoid, recognize the importance of medication review, and identify appropriate healthcare providers and sources of reliable preconception information. Data will be collected using structured questionnaires, standardized preconception-care knowledge assessment tools, scenario-based questions, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic, socioeconomic, and reproductive characteristics, previous pregnancy experiences, sources of health information, exposure to preconception education, and knowledge levels. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of health education on knowledge of preconception care. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that health education has a significant positive effect on knowledge of preconception care among women of reproductive age in Nigeria. Women exposed to structured, evidence-based, culturally appropriate, and sustained health education are expected to demonstrate greater knowledge of preconception care than women without comparable exposure. Education may improve understanding of the importance of preparing for pregnancy, managing existing medical conditions, improving nutrition, taking recommended folic acid supplements, maintaining healthy weight, receiving appropriate vaccinations, preventing infections, reviewing medications, avoiding harmful substances, and seeking professional healthcare before conception. Education may also correct the misconception that healthcare preparation begins only after pregnancy occurs and encourage women to discuss pregnancy intentions and health risks with qualified healthcare providers. However, limited access to healthcare facilities, financial barriers, cultural and family influences, low health literacy, inadequate reproductive health services, misinformation, and limited availability of preconception-care programmes may reduce the effectiveness of education alone. The study therefore expects accessible, practical, culturally sensitive, and sustained health education, supported by appropriate reproductive and primary healthcare services, to contribute significantly to improved knowledge of preconception care among women of reproductive age in Nigeria. The study is expected to contribute to the literature on preconception care, reproductive health education, maternal health, pregnancy preparation, women's health, health literacy, maternal and child health, preventive healthcare, family planning, 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, hospitals, reproductive health providers, community health workers, women's health organizations, development partners, and policymakers regarding strategies for strengthening preconception health. The study will also provide evidence-based recommendations for integrating preconception-care education into primary healthcare and reproductive health programmes, improving access to accurate preconception information, strengthening community health education, promoting early risk assessment and management, improving access to nutritional and preventive services, and developing sustainable interventions that improve knowledge of preconception care among women across Nigeria.

Keywords: Health education, preconception care, preconception-care knowledge, women of reproductive age, reproductive health, maternal health, pregnancy preparation, health literacy, preventive healthcare, family planning, Nigeria, public health.