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

Abstract

Preconception health is an important component of reproductive and maternal health because the health and well-being of women before pregnancy can influence fertility, pregnancy outcomes, and the health of both mother and child. Preconception care involves interventions undertaken before conception to identify and manage health conditions and risk factors, promote healthy behaviours, provide appropriate nutritional and micronutrient support, review medications and immunization status, address reproductive health concerns, and provide counselling on healthy pregnancy planning. Preconception health education is an important public health intervention for increasing women's knowledge of healthy behaviours and appropriate healthcare practices before pregnancy. In Nigeria, many women may enter pregnancy without adequate preparation because of limited awareness of preconception care, unplanned pregnancies, inadequate access to reproductive health information, financial constraints, cultural beliefs, and limited availability of preconception services. Inadequate preconception care may result in missed opportunities to identify and manage conditions or risk factors before pregnancy occurs. Effective preconception health education may improve women's knowledge, risk perception, health-seeking behaviour, and adoption of appropriate preconception care practices. Against this background, this study investigates the effect of preconception health education on preconception care practices among women of reproductive age in Nigeria. The study is anchored on the Health Belief Model (HBM), Social Cognitive Theory (SCT), and Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding women's decisions to adopt preconception care practices. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping health behaviours. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from preconception health education may influence appropriate preconception practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how preconception health education may influence preconception care practices among women of reproductive age in Nigeria. The study adopts a quantitative quasi-experimental research design. Primary data will be collected from women of reproductive age in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible participants. Where feasible, selected participants or healthcare facilities will be assigned to intervention and comparison groups. Women in the intervention group will receive structured preconception health education covering pregnancy planning, healthy nutrition, folic acid and other appropriate micronutrient considerations, prevention and management of chronic health conditions, reproductive health, sexually transmitted infection prevention, immunization, medication safety, avoidance of tobacco and harmful alcohol use, healthy weight management, mental well-being, genetic and family health considerations where appropriate, and the importance of seeking professional preconception care. Preconception care practices will be assessed using indicators such as utilization of preconception healthcare services, pregnancy planning, nutritional practices, appropriate micronutrient use, health screening, immunization review, management of existing health conditions, medication review, STI prevention, and adoption of healthy lifestyle practices before pregnancy. Descriptive statistics will be used to summarize participants' sociodemographic and reproductive characteristics, exposure to preconception health education, and preconception care practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be employed to determine the effect of preconception health education on preconception care practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, and the robustness of the findings. The study anticipates that preconception health education will have a significant positive effect on preconception care practices among women of reproductive age in Nigeria. Women exposed to structured preconception health education are expected to demonstrate improved knowledge of pregnancy preparation and greater adoption of appropriate preconception health behaviours. Education may encourage women to seek preconception consultations, identify and manage existing health conditions, adopt healthier diets, use appropriate micronutrient supplements, review medications, update relevant immunizations, prevent sexually transmitted infections, and avoid harmful substances. However, education alone may not guarantee optimal preconception care practices because women may face barriers such as limited access to preconception services, healthcare costs, unplanned pregnancies, cultural beliefs, inadequate family support, and limited availability of trained healthcare professionals. Consequently, preconception health education is expected to be more effective when integrated into routine reproductive health services and supported by accessible, affordable, confidential, and quality-assured healthcare. This study is expected to contribute to the literature on preconception health, reproductive health, maternal health, health education, pregnancy planning, and public health in Nigeria by providing empirical evidence on the effect of preconception health education on preconception care practices among women of reproductive age. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, primary healthcare facilities, hospitals, reproductive health programmes, community health workers, women's health professionals, development partners, and policymakers regarding strategies for improving preconception health. The study will also provide evidence-based recommendations for integrating preconception counselling into routine reproductive health services, strengthening community-based preconception education, improving access to preconception care, promoting healthy pregnancy planning, strengthening health screening and counselling before pregnancy, and increasing awareness of the importance of optimizing women's health before conception across Nigeria.

Keywords: Preconception health education, preconception care practices, women of reproductive age, reproductive health, pregnancy planning, maternal health, health education, preconception care, women's health, public health, Nigeria.