Feasibility of preconception care services in the Nigerian health system - an exploration of stakeholders' viewpoints
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School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
Division of Epidemiology and Biostatistics School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
Monitoring and Evaluation Department, Nigerian Institute of Medical Research, Lagos, Nigeria
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1077
Background and Objective: Preconception care (PCC) services aim to improve reproductive health outcomes through the provision of biomedical, behavioral and social health interventions to women and couples before conception occurs. Policy backing is important to guide PCC provision in the health system. In Nigeria, PCC is poorly developed, often provided in an opportunistic manner with no guidelines providing direction. This study explored policymakers’ and health workers’ opinions about the feasibility of deploying PCC services in the country. Methods: Using a cross-sectional exploration, 39 in-depth interviews were conducted with policymakers at the federal and state tiers of government as well as health workers at the tertiary, secondary and primary levels of health care. The transcripts were analyzed thematically using a hybrid of deductive and inductive coding. Results: The main themes identified were – issues around policy for PCC, service integration and collaboration, health system readiness and challenges to PCC service deployment. Noting that the country has no PCC policy, participants identified existing policies into which PCC can be integrated. The participants also described the importance of policy to PCC provision and provided information on existing collaborations for policy development and implementation. Although many participants believed the health system is prepared for PCC deployment, they identified challenges related to policy formulation and implementation that could hinder the process. Conclusions: The availability of health-related policies into which PCC guidelines can be integrated makes PCC service deployment achievable in the Nigerian health system. Potential implementation challenges need to be identified and addressed as part of the planning process.