Utilization of preconception care services among women of reproductive age in Kiambu County, Kenya
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Pre-conception care (PCC) is the provision of the biomedical, behavioral and social health interventions to women and couples before conception occurs. Despite the advances in maternal and neonatal care, Kenya still record a high maternal mortality rate with the leading maternal causes being hemorrhage and anaemia both of which can be prevented or adverse effects reduced through preconception care interventions. Kenya still reports a high number of unplanned pregnancies which poses a lot of health risks to both the mother and the unborn baby. The study aimed at assessing the utilization of preconception care services among women of reproductive age in Ruiru sub-county in Kiambu County . The objectives of the study were to find out on the knowledge on preconception care, uptake level of preconception care services and the factors that influence the utilization of these services by women of reproductive age. Descriptive cross-sectional study design was used with a target population of 65,045 women of reproductive age, para one and above in Ruiru sub-county. Simple random sampling method was used to select study participants. A total of 384 women of reproductive age took part in the study. A semi-structured interviewer-administered questionnaire was used to collect data and Focused Discussion groups. Quantitative data from the questionnaire was checked daily for completeness and coded for appropriate computer entry. Thematic content analysis was done for Qualitative data from the FGDs and triangulated during discussion. Thereafter, data was analyzed using SPSS version 20.0 statistical package. Univariate and bivariate data analysis were involved. Chi-square was used to determine the significance of associations between variables. Data finding were then presented using tables, pie charts and bar graphs. Findings showed that 61.7% had inadequate knowledge on preconception care services with the major source of information being from the health care providers in the hospital (66.3%). The uptake level of preconception care is fairly low with 80.2% of the women never used folic acid and only 20.3% were immunized against tetanus before conception. HIV testing during preconception period was the leading medical condition screened with 64.6% aware of their HIV status before conception. Findings further showed that there is a significant association between the knowledge level on preconception care and the age of the woman (χ2=10.976, P<0.05,df=1). Preconception folic acid use was significantly associated with occupation (χ2=5.766,df=1,P<0.05), education level (χ2=5.683,df=1,P<0.05) and area of residence (χ2=6.577,df=1,P<0.05). The conclusions from the study is that there is low level of knowledge on preconception care and uptake of the preconception care services is low among the women of reproductive age. The factors that influence its utilization include age of the woman, level of education, occupation, the cost of services, previous obstetric problems and partner support. The study recommended health education of women on preconception care and its importance, public awareness campaigns, women empowerment, male involvement for partner support during preconception period.