Preconception care utilization and associated factors in Sidama Region, Ethiopia, 2025: A community-based study

Preconception care (PCC) is crucial for preventing adverse pregnancy outcomes, as emphasized by WHO. However, its implementation in Ethiopia has been recent, despite the country having one of the highest maternal and perinatal mortality rates in the world. Previous studies on PCC were conducted before the national PCC guidelines were introduced, during a time of inconsistent care.

This study aimed to evaluate the prevalence of PCC utilization and identify the factors influencing its use in the Sidama Region of Ethiopia, following the implementation of the national guidelines.

A community-based, cross-sectional study was conducted from January 1 to January 30, 2025. Systematic random sampling was employed to recruit a total of 775 pregnant women. Data were collected using a structured, pretested questionnaire. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated to determine the independent predictors of PCC utilization.

The study revealed that the overall utilization of PCC was 10.3% following the implementation of national PCC guidelines. After controlling for potential confounders, women with primary education (aOR 2.05, 95% CI 1.06-3.97), secondary education (aOR 2.77, 95% CI 1.38-5.57), and a diploma or higher (aOR 3.79, 95% CI 1.75-8.23), as well as those with multiparity (aOR 4.47, 95% CI 1.71-13.34), family planning use (aOR 2.38, 95% CI 1.49-3.79), having a chronic medical illness (aOR 6.44, 95% CI 2.98-18.32), and history of adverse birth outcomes (aOR 2.11, 95% CI 1.02-4.34) were all significantly associated with the use of PCC services.

Only 10% of women utilized PCC. Key predictors for higher PCC utilization were women's education, multiparity, chronic medical conditions, contraceptive use, and previous adverse birth outcomes. The study underscores the need to empower women through education and increase access to contraceptives, as well as to raise awareness about the importance of PCC for all women planning to conceive.