Knowledge and Practice of Primigravida Women about Preconception Care in the Gaza Strip, Palestine

نجوى سليمان محمود أبو مصطفى
Najwa Suliman Mahmoud Abu Mustafa
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Background: Preconception care (PCC) may play a crucial role in reducing both immediate and long-term unfavorable health effects in mothers and their children. Aim: This study aimed to assess knowledge and practices of PPC among primigravida women in the Gaza Strip. Method and materials: A descriptive, cross-sectional design was utilized. A proportional quota sample was drawn from the main primary healthcare centers in the Gaza Strip, namely; Jabalia Martyrs, Al Rimal Martyrs, Al Daraj, Al Zytoun, Deir Al-Balah Martyrs, Khanyounis Martyrs, and Rafah Martyrs. The sample size was 376 primigravida women who visit the ANC service. Targeted women were interviewed using an interviewing questionnaire, a pilot study was conducted, the study began from January to august 2022, Cronbach alpha reliability was 0.905, and validity was assured by experts in the field. Results: The mean age of the study sample is 22.3. The majority, 53.2%, married before the age of 20, and 51.1% live in Gaza City. 94.7%, are unemployed. 55.9% of women have a high level about PCC knowledge (mean: 5.6) 46.5% of women have good practice, with a mean score of 9 (0-26). Two-thirds of women found PCC easy to obtain. The correlation between respondents’ knowledge and practice is moderate (r=0.507, p=0.000). There was a statistically significant link between respondents' knowledge and the presence of a PCC unit (chi= 32.2, p = 0.000), folic acid (𝑥2= 42.1, p = 0.000), and medical lab tests (𝑥2= 30.8, p-value = 0.000). Also, there was a statistically significant relationship between respondents' level of practice and accessibility to a health care center (𝑥2= 11.7, p = 0.003), the presence of a PCC unit in the health facility (𝑥2= 32.2, p = 0.000), and the availability of folic acid and lab tests. Age and age at marriage had statistically significant relationships with respondents' knowledge (𝑥2=8.32, p=0.016) and (𝑥2=6.53, p=0.038), respectively. The location also affects participants' knowledge, with most middle-zone women (90.5%) having a high level (p=0.000). The majority of university-educated women (65.4%) have a high degree of practice. Those with secondary education or less had a high level of knowledge (𝑥2=14.4, p=0.001). 61.4% of those with a university education, 56.3% of those with a secondary school, and 40% of husbands with preparatory education or less had good knowledge. The place of residence determines women’s practice, with 76.2% of middle-zone women demonstrating excellent practice. North Gaza had 71.4%, Gaza 47.9 Khanyounis 27.1%, and Rafah 18.2% (p=0.000). The multivariate regression model found two variables that predict women's knowledge. First: education (P=0.03), women with a bachelor's degree or more have a higher PCC knowledge four times more than those with less educated (OR: 4, P = 0.015). Second: practice, those with the good practice category have a higher knowledge of 3.7 times more than those with the poor practice category (OR: 3.7, p=0.000). The model found three variables that predict women's practice. First: Place of residence (P=0.000). Middle zone women enhance their practice score 3.2 times higher than their Rafah counterparts (OR: 3.2, p= 0.031). Living in Gaza City increases women's practice by 3.3 times compared to Rafah (OR: 3.3, p= 0.006). Living in North Gaza increases women's practice by 3 compared to Rafah (OR: 3.2, p= 0.000). Second: knowledge, high knowledge increases practice by 3.6 times more than poor knowledge (O.R: 3.6, P = 0.000). Third, hospital accessibility. Women who found access to health care centers "difficult" were 0.87 times less likely to practice than those who found it "easy" (OR: 0.130, P= 0.012). Conclusion and recommendations: The study concluded that primigravida women have good knowledge and high practice about PCC service. Women's and families' knowledge and practice about PCC services should be increased by holding education sessions for any woman visiting PHCC and giving an interest in this topic in the clinics' brochures, posters, and boards containing encouraging phrases.
نجوى ابو مصطفى,معرفة وممارسة نساء البكارى حول رعاية ما قبل الحمل في قطاع غزة، فلسطين رسالة ماجستير جامعة القدس ابو ديس