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Impact of Preconception Health Screening on Early Detection of Health Conditions among Women Planning Pregnancy in Nigeria

Abstract

Preconception health is an important component of reproductive and maternal healthcare because a woman's health status before pregnancy may influence her pregnancy experience, maternal well-being, and fetal and newborn outcomes. Women planning pregnancy may have undiagnosed or poorly controlled health conditions such as hypertension, diabetes, anaemia, infections, nutritional deficiencies, obesity, and other medical or reproductive health concerns that may affect pregnancy if not identified and appropriately managed before conception. In Nigeria, limited awareness of preconception care, financial constraints, inadequate access to healthcare facilities, and delayed healthcare utilization may reduce opportunities for early identification and management of these conditions. Preconception health screening provides an opportunity to assess women's health before pregnancy and facilitate timely counselling, treatment, referral, and risk reduction. Against this background, this study investigates the impact of preconception health screening on early detection of health conditions among women planning pregnancy in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Social Ecological Model. The Health Belief Model explains how women's perceptions of their susceptibility to health conditions, perceived severity, perceived benefits of preconception screening, perceived barriers, and cues to action may influence participation in screening services. Andersen's Behavioral Model explains healthcare utilization through predisposing characteristics, enabling resources, and perceived or evaluated health needs. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, healthcare-system, and broader socioeconomic factors on access to and utilization of preconception healthcare. Collectively, these theoretical perspectives provide a suitable framework for explaining how preconception health screening may influence early detection of health conditions among women planning pregnancy in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women of reproductive age who are actively planning pregnancy and attend selected primary healthcare facilities, hospitals, reproductive health clinics, or community health programmes across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, healthcare facilities, communities, and eligible participants. Preconception health screening will be assessed using indicators such as availability and uptake of preconception consultations, medical history assessment, blood pressure measurement, body mass index assessment, blood glucose testing where indicated, haemoglobin or anaemia assessment, infection screening according to relevant guidelines, nutritional assessment, reproductive health assessment, medication review, immunization assessment, and appropriate laboratory investigations based on individual risk. Early detection of health conditions will be assessed using indicators such as newly identified hypertension, abnormal blood glucose levels or suspected diabetes, anaemia, nutritional deficiencies, infections, obesity, reproductive health conditions, previously undiagnosed chronic diseases, identified pregnancy-related risk factors, referrals for further assessment, and initiation of appropriate management before conception. Data will be collected using structured questionnaires, clinical records, laboratory results, screening registers, referral records, and relevant preconception health programme documents, subject to appropriate ethical and confidentiality safeguards. Descriptive statistics will be used to summarize participants' characteristics, screening uptake, detected health conditions, and referral patterns. 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 impact of preconception health screening on early detection of health conditions. Where a quasi-experimental design is adopted, detection rates before and after implementation of the screening programme 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 preconception health screening has a significant positive impact on early detection of health conditions among women planning pregnancy in Nigeria. Women who participate in comprehensive preconception screening are expected to have a higher likelihood of previously undetected health conditions and pregnancy-related risk factors being identified before conception. Early identification may provide opportunities for appropriate treatment, lifestyle modification, nutritional support, medication review, infection management, immunization, specialist referral, and other interventions that may improve women's health before pregnancy. Preconception screening may also encourage women to become more aware of their health status and seek appropriate professional advice before conception. However, financial barriers, limited availability of screening services, inadequate laboratory capacity, shortage of healthcare personnel, low awareness of preconception care, cultural beliefs, and delayed healthcare utilization may reduce screening uptake and programme effectiveness. The study therefore expects accessible, affordable, comprehensive, and well-integrated preconception health screening services to contribute significantly to improved early detection and management of health conditions among women planning pregnancy in Nigeria. The study is expected to contribute to the literature on preconception health screening, early detection of health conditions, preconception care, women's reproductive health, maternal health, preventive healthcare, 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 facilities, hospitals, reproductive health services, obstetric and gynaecological care providers, community health workers, women's health organizations, development partners, and policymakers regarding strategies for strengthening preconception healthcare. The study will also provide evidence-based recommendations for integrating comprehensive health screening into routine preconception services, improving access to affordable laboratory investigations, strengthening counselling and referral systems, increasing awareness of preconception care, and developing sustainable preconception health programmes for women planning pregnancy across Nigeria.

Keywords: Preconception health screening, early detection, women planning pregnancy, preconception care, reproductive health, maternal health, preventive healthcare, health screening, primary healthcare, Nigeria, public health.