Abstract

Background: Preconception care is the care given to a couple in order to prepare a conducive environment for the baby by intervening and treating diseases in time. Both the father and mother behave a part to play in preconception care for it to be effective.

Objectives: To assess the knowledge, attitude, and practice of preconception care among men of reproductive age, to determine factors or barriers to the practice or uptake of preconception care. This study was done on men of 21-49 years.

Method: The study was a cross-sectional descriptive community-based study carried out from May to July 2021. Pre-tested structured questionnaires were used for the collection of data. 300 participants out of the 383 estimated sample size were interviewed.

A convenient sampling method was used to attain our sample size. The data collected were verified, coded, and analyzed using SPSS version 20 for descriptive analysis and the Chi-square test was used for P-values.

Results: 40.4% were well informed on PCC and received this information from the hospital. The majority of the participants,41.4% (n=124) of the men in this study had a good knowledge of preconception care.

The overall practice level of preconception was good 59.7%, and 70.3% of participants had a good attitude towards preconception care and realized the importance of preconception care.69.7% of the participants reported that u availability of services was the major reason for the non-uptake of preconception care.

Socio-demographic variables such as age and occupation were statistically significant when associated with the practice of Preconception care with P-values 0.000 and 0.000 respectively.

Conclusion: Men of reproductive age in the Buea Health District have good knowledge, practice, and a positive attitude towards preconception care.

Recommendation: Health care centers should establish well-defined services for men’s preconception health such as organizing preparation to fatherhood classes where information and necessary interventions could be done. Also, more education should be done on family planning and the importance of planning pregnancies.

CHAPTER ONE

INTRODUCTION

1.1 Background Of The Study

Preconception care is defined as individualized care for men and women that is focused on reducing maternal and fetal morbidity and mortality, increasing the chances of conception when pregnancy is desired, and providing contraceptive counseling to help prevent unintended pregnancies. [1].

Preconception care was introduced in order to ensure continuity of child health care and also as a means of preventing diseases or conditions that may affect the woman’s reproductive health, in one of the first federal proposition papers in 1979 in the United States [2].

Preconception care (PCC) as defined by the CENTER FOR DISEASE CONTROL (CDC) is a set of interventions that aim to identify and modify biomedical, behavioural, and social risks to a woman’s health or pregnancy outcome through prevention and management [3].

PCC was generally geared towards women, due to the unquestionable evidence of maternal factors influencing the baby either in utero or throughout the course of the infant’s life. Based on previous studies, maternal age is one of the factors which can affect the fetus according to a study carried out by Fuchs et al, advanced maternal age (40 years and over) was associated with preterm birth [4]. More studies provide evidence on the relationship between maternal factors prior to conception and the wellbeing of the pregnancy [5, 6, 7]. In Africa, studies have been carried out assessing women’s knowledge and practice of preconception care.

In Nigeria for example, precisely in Osun state, a study was carried out on the knowledge and uptake of preconception care by the women in that area. Results from that study showed that most of the women (63.5%) were knowledgeable on preconception care.

Even though most of the respondents were knowledgeable about preconception care, the result showed that the majority (65.9%, n= 247) of the respondents have not sought the care before pregnancy while only 34.1% (n= 128) have asked about it in the hospital. [8]

More and more researchers grew interested in PCC and they found out that given the fact that it takes male sperms to fertilize the egg(s), and these sperms transfer genetic material which will make up part of the genetic content of the baby to be born, paternal factors prior conception have to be investigated [9].

The reason why men have a part to play in the preconception plan. some of these factors include the father’s nutrition and lifestyle. It can influence pregnancy outcomes in a number of ways.

In the pre-conception period, several modifiable factors in paternal behaviour and nutrition can influence sperm count and quality, and consequently affect fertility. For example, sperm count and quality are affected by alcohol, recreational drugs, prescription drugs, infections, tobacco, and environmental toxins, as well as the man’s BMI and metabolic health state.

A father’s metabolic status may also have some impact on the metabolic trajectory of his offspring [10]. Other aspects of a father’s behaviour can indirectly affect the developing fetus through occupational and environmental exposures.

Prospective fathers need to be conscious of their personal health and nutrition, as well as of environmental factors that may influence both their ability to conceive and the health of their future offspring [9]. Few data have been gathered as to what concerns preconception care for men.

Out of the few was a study carried out by Keith et al which was to determine if men realize the importance of optimizing their health prior to pregnancy, whether the pregnancy is planned or not; and to evaluate their knowledge level and beliefs about preconception healthcare. Their results showed that the population studied revealed some significant knowledge deficiencies about factors that may threaten their health or the health of their partner’s fetus.

Also, Nearly all men (93.2%) realized the importance of optimizing their health prior to a pregnancy and realized the best time to receive information about preconception health was before conception. [11].

In Africa, a qualitative study carried out in Nigeria on both men and women to assess their PCC practices showed that the level of practice was very low [12]. More data has to be gathered as to what concerns preconception care for men in developing countries. Reason for this study.

1.2 Problem Statement 

It takes two to have a baby, the role played by the man in conception is vital. Research shows that the quality of the lifestyle and health of the male partner or father-to-be can have an impact on the wellbeing and health of the baby in utero and even in the later years of the infant’s life [4].

The domain of preconception care has greatly been geared towards women, leaving the men untouched meanwhile some of the complications during pregnancy and some causes of infant mortality such as prematurity and stillbirth, and other health complications are sometimes influenced by paternal factors [13].

Despite the body of knowledge on the impact of paternal factors prior to conception on the infant, studies on male preconception care in Cameroon follow a similar pattern in which little data on the subject matter is acquired. The reason why the topic” knowledge, attitude and practice of preconception care by men in the Buea Health District” is been carried out, to gauge what is on the field and create awareness on this important but yet neglected aspect.

1.3 Objectives.

1.3.1 General objectives

This research aims at assessing the knowledge, practice, and attitude of men towards preconception care in the Buea Health District.

1.3.2 Specific Objectives

1. To assess the knowledge of men in the Buea Health District on preconception care
2. To assess the level of practice of preconception care by men
3. To determine their attitude towards the practice of preconception care.
4. To determine the barriers (factors) which influence the adherence of men to the uptake of preconception care.

 1.4 Research questions

The major research questions for investigation in this study include the following:

1. What knowledge do men in the Buea Health District know about preconception and the preconception care packages available?
2. What is the attitude/perception of men towards preconception care?
3. What is the practice of preconception care by the men in the Buea Health District?
4. What factors influence their uptake of preconception care.

1.5 Hypothesis of the study.

Null hypothesis: Men in the Buea Health District have a poor knowledge, attitude and practice of preconception care.

Alternate hypothesis: Men in the Buea health district have good knowledge, attitude, and perception care.

1.6 Rationale of study

The purpose of this study is to provide an insight on the level of knowledge and the perception of preconception care by men in the Buea Health District knowing that continuity of care is a better means of promoting a favourable maternal and infant outcome. As such this study is to assess if men practice preconception care and also if their knowledge and attitude towards preconception care affect their practice.

More to that, it is a means of creating awareness on the fact that paternal factors also influence the outcome of conception and health of the infant. So, emphasis should not only be laid on the mother but also on the father-to-be.

Also, I have a personal interest in this area because I believe continuity of care is an essential step in reducing maternal and infant mortality hence, I am carrying out this research to gain more information so as to be knowledgeable enough to open a preconception care and fertility clinic.