Health Providers’ Self Reported Provision of Preconception Care and Associated Factors in Kisumu County-kenya

Abstract

Abstract Background Preconception care (PCC) is the provision of health interventions to women and couples before conception occurs and is valuable in preventing and controlling noncommunicable diseases. In Africa, more so in Kenya, maternal and neonatal health indicators have remained poor. The key constraint limiting progress has been the gap between what is needed and what exists in terms of skills and human resources and infrastructure. This gap was yet to be measured for PCC in Kenya, more so in Kisumu County. Methods. Using a cross-sectional design, this study specifically sought to determine the rate of self-reported PCC provision and to illustrate how it is influenced by health provider characteristics. Structured interviews were conducted with health providers (n=476) to ascertain their knowledge, perceptions and practice of PCC care. The significance of the differences in proportions was determined by the x2. Student’s t test and linear regression were used to show the relationship between the factors and the PCC provision rate. Results. Self-reported PCC provision was estimated at 37%. There was a significant difference in the mean for cadres {nurses (M=70.04, SD=8.951) and non-nurses (M=71.90, SD=8.732); t (473) =-2.23, P=0.026)}, years of experience up to 5 years (M=72.04, SD=8.417) and more than 5 years (M=69.89, SD=9.283); t (465) =2.63, P = 0.009. PCC inclusion in reporting tool was a significant predictor (β=0.6, t (26) =8.64, P<0.001, 95% CI=0.46-0.74) of provision. The mean provision per level (M=60.21, SD=4.902; t (26) =-5.06, P<0.001) and type of service (M=69.36, SD=4.924; t (26) =4.63, P<0.001) were significantly different. The health workers felt PCC was an important service whose provision was low due to inadequate human capital investment. Conclusion. Self-reported provision of PCC by health workers was relatively low and was influenced by the cadre of health workers and their years of experience. It was also demonstrated that the inclusion of PCC in reporting systems, the levels and types of facilities were significant predictors of self-reported provision of PCC. Investing in on-the-job training for health providers, especially nurses, establishing a reporting system for PCC activities, and providing care in primary health facilities in rural areas can improve PCC service delivery.