Perceptions of and challenges faced by primary healthcare workers about preconception services in rural India: a qualitative study using focus group discussion
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Authors
Chutke, Amruta Paresh
Doke, Prakash Prabhakarrao
Gothankar, Jayashree Sachin
Pore, Prasad Dnyandeo
Palkar, Sonali Hemant
Patil, Archana Vasantrao
Deshpande, Aniruddha Vinayakrao
Bhuyan, Khanindra Kumar
Karnataki, Madhusudan Vaman
Shrotri, Aparna Nishikant
Issue Date
2022-08-17
Type
Article
Language
en_US
Keywords
Preconception Care , Qualitative Research , Focus Group Discussion , Socio-Ecological Model , Healthcare Workers , Challenges , Suggestions
Alternative Title
Abstract
Background:
Providing preconception care through healthcare workers at the primary health care level is a crucial intervention to reduce adverse pregnancy outcomes, consequently reducing neonatal mortality. Despite the availability of evidence, this window of opportunity remains unaddressed in many countries, including India. The public health care system is primarily accessed by rural and tribal Indian population. It is essential to know the frontline healthcare workers perception about preconception care. The study aimed to identify barriers and suggestions for framing appropriate strategies for implementing preconception care through primary health centers.
Methods:
The authors conducted a qualitative study using focus group discussions (FGDs) with 45 healthcare workers in four FGDs (8–14 participants in each), in four blocks of Nashik district. The transcribed discussions were analyzed in MAXQDA software using the Socio-Ecological Model as an initial coding guide, including four levels of factors (individual, interpersonal, community, and institutional) that influenced an individual's behavior to use preconception care services.
Results:
Healthcare workers had some knowledge about preconception care, limited to adolescent health and family planning services. The interpersonal factors included heavy workload, stress, lack of support and co-operation, and paucity of appreciation, and motivation. The perceived community factors included poverty, migration, poor knowledge of preconception care, lack of felt need for preconception services, the influence of older women in the household decision, low male involvement, myths and misconceptions regarding preconception services. The identified institutional factors were lack of human resources, specialized services, logistics, and challenges in delivering adolescent health and family planning programs. Healthcare workers suggested the need for program-specific guidelines, training and capacity building of human resources, an un-interrupted supply of logistics, and a unique community awareness drive supporting preconception care services.
Conclusion:
Multi-level factors of the Socio-Ecological Model influencing the preconception care services should be considered for framing strategies in the implementation of comprehensive preconception care as a part of a continuum of care for life cycle phases of women.
Description
Citation
Chutke, A. P., Doke, P. P., Gothankar, J. S., Pore, P. D., Palkar, S. H., Patil, A. V., Deshpande, A. V., Bhuyan, K. K., Karnataki, M. V., & Shrotri, A. N. (2022). Perceptions of and challenges faced by primary healthcare workers about preconception services in rural India: A qualitative study using focus group discussion. Frontiers in public health, 10, 888708. https://doi.org/10.3389/fpubh.2022.888708
Publisher
Frontiers in Public Health