Understanding Community Perceptions, Preparedness, and Expectations of Preconception Care: A Formative Research Approach

Understanding Community Perceptions, Preparedness, and Expectations of Preconception Care: A Formative Research Approach | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Understanding Community Perceptions, Preparedness, and Expectations of Preconception Care: A Formative Research Approach Swati Misra, Kamlesh Mahajan, Mohini Gawai, Abhishek V. Raut, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5749029/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective : The study explores community perceptions, preparedness, and expectations regarding preconception care (PCC). It evaluates the acceptance of nurses delivering PCC services, the efficiency of a community-based PCC package, and community readiness for village-level PCC services, aiming to co-develop a tailored PCC package. Methods : This formative research employed a qualitative approach, including focus group discussions (FGDs), in-depth interviews (IDIs), and free listing and ranking exercises. Conducted in 96 villages across four Primary Health Centres in rural Maharashtra, the study involved diverse participants, including eligible couples, village representatives, and community health workers. Data were analyzed using thematic content analysis, employing both deductive and inductive methods to identify themes related to perceptions, contributions, and expectations for PCC. Results : The study revealed gaps in community awareness of PCC, including genetic screening and early detection. Despite this, members emphasized PCC’s benefits, such as improved maternal health and safer deliveries, showing strong support for accessible clinics with local involvement. Unique priorities like health screening, family wellbeing, and lifestyle modifications enriched PCC, reflecting a holistic approach. Conclusion : The findings highlight the community's readiness to adopt PCC services, provided they are affordable, accessible, and tailored to local needs. The study underscores the importance of culturally sensitive approaches and leveraging community networks to promote PCC. Integrating locally prioritized areas into PCC frameworks can enhance maternal and child health outcomes and ensure effective implementation in resource-limited settings. Women's studies Sexual & Reproductive Medicine Preventive Medicine Task-Shifting Strategy Sustainable Healthcare Models Community Engagement Panchayat Resource Persons Preconception Health Care Community-Based Interventions Participatory Learning and Action Figures Figure 1 Figure 2 Background Over the years, advancements in antenatal care have significantly reduced maternal and neonatal mortality. Yet, despite these improvements, an estimated 800 women and 6,700 newborns continue to die daily from preventable complications related to pregnancy and childbirth. The burden of these deaths is disproportionately high in low- and middle-income countries, where unplanned pregnancies, preterm births, birth defects, complications during labor, and infections are the primary contributing factors [ 1 ]. Globally, half of maternal deaths are attributed to just three causes: haemorrhage, hypertensive disorders, and sepsis [ 2 ]. Relying solely on antenatal care has proven to be insufficient, as it fails to address health issues that emerge before or in the early weeks of pregnancy. In low-resource settings, the first antenatal visit often occurs too late to detect and manage problems that contribute to maternal and neonatal mortality and morbidity. This highlights the need for earlier interventions and comprehensive care strategies to improve outcomes [ 3 ] Role of Preconception Care in Improving Health Outcomes Much of the maternal and neonatal mortality and morbidity has its roots in the preconception period. Therefore, providing care before pregnancy, known as preconception care (PCC), is crucial in preventing maternal and child mortality and morbidity. Preconception care involves a set of interventions offered to women and couples before conception, aiming to improve and promote favorable neonatal and birth outcomes. By identifying and addressing modifiable risks to maternal and fetal health, it leverages social, behavioral, and medical interventions to optimize health before pregnancy [ 4 – 6 ]. Preconception care has the potential to significantly improve maternal and child health outcomes. Recognizing this, the WHO has developed a comprehensive preconception care package that covers 13 key areas. The WHO strongly recommends its global implementation to address critical health needs before pregnancy [ 7 , 8 ]. Challenges and Opportunities for Preconception Care in India Currently, India lacks a dedicated public health program for providing regular PCC services, with existing interventions scattered across various policies. The delivery of PCC interventions faces challenges due to the absence of specific socio-cultural guidelines, limited understanding of community needs, lack of awareness, and resource constraints among healthcare providers. This formative research aims to address these gaps by enhancing the understanding of these factors. It forms part of a stepped-wedge cluster randomized implementation trial that will assess the impact of a community-based preconception care package, delivered by trained nurses, on preconception health, maternal health, and child health outcomes. It is recognized that government healthcare facility doctors will have limited involvement in delivering PCC to the community, as they are already burdened with providing curative and preventive services. To address this, a task-shifting strategy has been implemented, where trained nurses take on the responsibility of delivering PCC services [ 3 , 9 ]. This study aims to explore the community's acceptance of nurses in delivering preconception care (PCC) services, assess the efficiency of nurses in providing the PCC package, and understand community perceptions, preparedness, and expectations regarding PCC. Additionally, it will determine the community's readiness to engage with PCC services if made available at the village level. A key focus of the study is to co-develop a comprehensive PCC package in consultation with the community, ensuring it addresses their specific needs and encourages active contribution toward improving maternal and child health outcomes. Methods Study Design and Methods This formative research was conducted using a qualitative approach to assess community perceptions, preparedness, and expectations regarding PCC. It was conducted as part of a stepped-wedge cluster randomized implementation trial, with the goal of co-developing a community-based PCC package delivered by trained nurses. The research adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines, ensuring transparency, rigor, and a systematic approach throughout the study. The qualitative methods employed included focus group discussions (FGDs), in-depth interviews (IDIs), and free listing and ranking exercises. The fieldwork for this research was conducted between March to June 2024. Study Settings The study was conducted in 96 villages across four Primary Health Centres (PHCs) located in the Wardha Community Development Block of Maharashtra, India. These villages ranged in size, with populations between 300 and 10,000, covering a total population of approximately 120,000 people. Peri-urban villages within a 5-kilometer radius of Wardha town were excluded from the study to focus on rural community. The PHCs involved were: PHC An: 28 villages PHC Kh (G): 25 villages PHC Ta (Wa): 25 villages PHC Wa: 26 villages Sample size, Participants and Sampling method The sample size for this formative research was determined based on the need to gather diverse and comprehensive perspectives from different community members regarding preconception care (PCC). As the study utilized qualitative methods, it adhered to the principle of data saturation. Saturation was reached when no new information or themes emerged from the data collection, ensuring that the sample was sufficient to meet the study's objectives. Table S1 (Supplementary Material) provides a matrix outlining the data collection methods, their objectives, and the associated sample sizes. Participants were selected using purposive sampling based on the following eligibility criteria: Eligible couples : Newly married couples planning for a baby or couples who already had one or more children and were planning for another child. Key informants : Village Representative like: Sarpanch (Village Head), Gram Sabha members (Village Council members), ASHA workers (Community Health workers), Anganwadi Sevika (Village Childcare workers), Police Patil (Village Police representatives), Other community members like Male and Female CRP (Community Resource Person), PRP (Panchayat Resource Person), and Bachat Gat members (Women Self-help group members). Non-Participants : Eligible couples with either partner using permanent contraception were excluded from the study. Data Collection Process Field techniques included establishing rapport with villagers through prior meetings, where the concept of PCC was thoroughly explained. It was also ensured that the village head was informed in advance about the purpose of the study to gain their support and involvement. Following these initial engagements, eligible couples were informed about the study and approached through their respective village representatives to encourage participation. Data collection methods were planned based on the population of the villages. In more densely populated villages with group gram panchayats, separate FGDs were conducted for men and women. In smaller villages, a combination of qualitative methods was used, but all key informants across the study area were approached for IDI. The initial step of the fieldwork involved conducting IDIs, which helped the team to understand the overall status of the village. This included gathering information on the number of eligible couples and the community's views on healthcare services, such as antenatal and postnatal care (ANC and PNC). The insights gained from these IDIs also helped in organizing participants for subsequent FGDs and Free Listing & Ranking exercises. The project team received training on qualitative data collection methods, and all data collection activities were conducted under the supervision of an anthropologist to ensure methodological rigor. The primary method of engagement with villagers and higher village authorities was face-to-face interaction, which allowed the team to build rapport. In some cases, telephonic conversations were used to facilitate further communication and coordination with village representatives. The profiles for male FGDs, female FGDs, and IDIs are detailed in the Tables S2–S4 (Supplementary Material). Voice recordings of the interviews, lasting 30–40 minutes, were taken, while sociograms and detailed field notes captured participant interactions and key observations during the sessions. Female FGDs were conducted during the day, with ASHA informing participants in advance. Data collection methods were held in various village locations, including Anganwadi centers, schools, temples, or participants' homes. Male FGDs, conducted in the evening, posed challenges due to the availability of participants, with frequent off-topic queries and cross-questions directed at female facilitators, making each session unique. For free listing and ranking, participants listed their expectations for the village PCC clinic on chart paper, with individual scores assigned based on the total number of expectations. Data Analysis The data collected from the FGDs, IDIs, and free listing & ranking exercises were analyzed using thematic content analysis. A mixed approach was used for data analysis. Initially, a deductive approach was applied, using predefined themes based on the research objectives, while remaining open to new themes that emerged inductively from the data. This combination allowed for structured analysis while accommodating the discovery of unexpected insights. The analysis followed a systematic approach to identify recurring themes and patterns in community perceptions, preparedness, and expectations regarding PCC. Transcription and Translation : Audio recordings from the FGDs and IDIs, conducted in the Marathi language, were transcribed verbatim by trained ANMs. These transcriptions, along with detailed field notes and sociograms, were reviewed by two independent researchers to ensure an in-depth understanding of the data. Familiarization with the data was achieved through repeated reading of the transcripts, which allowed the researchers to immerse themselves in the content. Coding : For the coding of the qualitative data, a manual approach was used with three coders to ensure consistency, accuracy, and inter-coder reliability throughout the analysis. Initial coding was conducted by two independent researchers, who reviewed the transcripts line by line, identifying key phrases, ideas, and recurring thoughts shared by the participants. The coding process involved identifying first-order codes, which were based on direct responses from participants. The codes represented recurring topics such as PCC Perceptions, PCC Contribution, PCC Expectation. Development of Sub-themes and Themes : After the first-order codes were identified, the researchers grouped similar codes into second-order sub-themes. These sub-themes captured more specific aspects of the participants' views and experiences. The sub-themes were further consolidated into higher-order themes based on their conceptual similarity. Consensus and Validation : To ensure the reliability of the themes and sub-themes, the coding and thematic structure were discussed among the research team, including the Principal Investigator. Discrepancies in coding and theme identification were resolved through discussion until consensus was reached. In addition to thematic analysis, a quantitative aspect was incorporated by calculating respondent frequency for each first-order code, indicating how many participants shared a specific view. This helped prioritize the most frequently mentioned and important themes. The final themes were refined and reviewed in collaboration with the Principal Investigator. This ensured that the themes accurately captured the key insights related to community readiness for PCC and addressed the study objectives. The finalized themes provided a comprehensive understanding of community perspectives, including their expectations from PCC services and the challenges they faced in accessing care. Triangulation Triangulation was employed in this study to enhance the validity and reliability of the findings by incorporating data from multiple qualitative methods—FGDs, IDIs, and Free Listing & Ranking exercises. Methodological triangulation ensured that data collected through FGDs, which captured group perceptions, were cross-validated with insights from IDIs, providing detailed individual perspectives, and Free Listing & Ranking, which highlighted specific community expectations regarding PCC. Data source triangulation involved gathering information from diverse participants, including newly married couples, key informants like Sarpanch, ASHA workers, and Anganwadi Sevikas, and couples planning for another child, ensuring a comprehensive understanding of community views. Additionally, investigator triangulation was applied, with two independent researchers conducting the initial coding and thematic analysis, and any discrepancies being resolved through discussions with the Principal Investigator. This triangulation approach strengthened the study's conclusions by ensuring consistency and depth across multiple data sources and methods. Ethical consideration Ethical approval for the research was obtained from the Institutional Ethics Committee (IEC) for Research on Human Subjects at MGIMS prior to the study's initiation, in accordance with IEC approval letter no. IEC/406/2023, dated 30 December 2023. Verbal informed consent was taken by each participant for their participation and audio recording. Results The results of this formative research provide valuable insights into the community's understanding and engagement with PCC. Emerged themes reflect the community’s perceptions of PCC, their contributions toward implementing PCC practices, and their expectations of such services. The findings are organized into distinct thematic categories, each illustrated with direct quotes from participants to highlight the perspectives shared. The analysis is presented in the following sections, detailing the core themes that have emerged from the data. Community Perceptions of PCC: Thematic Insights from FGDs & IDIs Contributions to PCC: A Thematic Review from FGDs & IDIs Expectations for PCC Services: Thematic Findings from FGDs & IDIs Expectations for PCC: Insights from Free Listing and Ranking Analysis Figure 1 outlines the barriers, perceptions, and benefits of Preconception Care (PCC) using a community-based mind map. The higher-order theme in Table 1 is Community Perceptions of PCC . The table reveals that, while the community recognizes the advantages of PCC, there is still a significant lack of awareness, particularly regarding early disease detection, genetic screening, and preparing for a healthy pregnancy. Cultural norms, such as the strong preference for male children, persist and often influence reproductive decisions. Respondents emphasized the importance of inter-conception care, particularly the need for proper spacing between children to ensure adequate nutrition for both mother and child. They highlighted the benefits of PCC, including improved maternal and child health, safer deliveries, and the convenience of having a PCC clinic in the village, which would save time and money by providing timely care. Additionally, respondents stressed the importance of blood tests before conception, mentioning tests for HIV, blood pressure, sugar levels, genetic disorders, and vaccines like tetanus. There was also a focus on the period of care for trans-generational diseases, with many agreeing that treatment for genetic disorders should begin 1-2 years or at least six months before conception to ensure a healthy baby. Commonly discussed trans-generational diseases included blood pressure, diabetes, thyroid issues, and genetic conditions, all of which respondents believed should be treated before pregnancy. While the community expressed a desire for PCC clinics, particularly in remote areas, concerns about affordability and accessibility were raised. Some participants suggested that fees should be minimal, as many struggle with paying taxes and may avoid attending the clinic if the costs are too high. In contrast, villages with existing healthcare centers showed less interest in new PCC services. The role of ASHA workers in educating adolescent girls (Kishori) was also emphasized, as they are the future mothers and often suffer from anemia. Finally, respondents highlighted the importance of self-care before conception, including regular health monitoring, genetic testing, a nutritious diet, and taking the necessary PCC vaccines. Couples should be aware of their own and their partner’s health status before planning a pregnancy. Overall, the community showed a readiness to adopt PCC but needs increased education, financial support, and accessible services to ensure successful implementation. The higher-order theme in Table 2 is Contributions to Preconception Care , which encompasses the community's role in managing, promoting, and supporting the PCC clinic. The table reveals that management responsibility could be shared among various local figures, such as ASHA workers, self-help groups, bachatgut members, and even educated youth, demonstrating flexibility and inclusivity in leadership. Promotion of the PCC clinic is expected to rely heavily on grassroots efforts, including discussions during local meetings, women’s groups, ASHA workers, and informal platforms like WhatsApp groups. The community showed readiness to contribute financially, with suggested amounts ranging from INR 50/- to INR 1000/-, depending on individual economic capacity. This indicates a general willingness to support the clinic despite varying financial capabilities. Additionally, several potential locations for the clinic were identified, including Gram Panchayat offices, Anganwadi centers, schools, and even available rooms in PHCs or government hospitals. The need for coordination with local authorities, like the Sarpanch, was also emphasized. Overall, the analysis reflects strong community support for the PCC clinic, relying on local resources, networks, and leadership to ensure its success. The higher-order theme in Table 3 is Expectations for PCC Services, which captures the community’s anticipated services and support from PCC clinics. The community expressed the need for a broad range of healthcare facilities, including essential tests like blood tests, sonography, vaccines, and emergency care, particularly for conditions like infertility, asthma, and chronic diseases. Additionally, there is a strong demand for counselling services, covering areas such as family planning, safe pregnancy practices, hygiene, spacing between children, and counselling for newlyweds and in-laws. Affordability is a crucial factor, with many participants advocating for low or no fees, particularly for those living below the poverty line. The community also highlighted the importance of providing targeted health education for adolescent girls (Kishori) to prepare them for future motherhood. Respondents emphasized the need for both male and female doctors, gynecologists, and nurses, especially during emergencies, with nurses managing ongoing care after the first visit. Overall, the community’s expectations reflect a desire for comprehensive, affordable, and accessible PCC services, emphasizing the importance of education, counselling, and full medical support. The Table 4 presents the ranking exercise analysis of facility expectations for Preconception Care (PCC) across various villages serviced by different Primary Health Centers (PHCs) in the region. This free listing and ranking exercise provide insights into the relative prioritization of different PCC packages based on the needs and preferences expressed by the communities. Nutritional Conditions (NC) and Health Screening (HS) consistently rank high across most villages, indicating a widespread emphasis on basic health and nutrition as foundational to preconception care. Anji PHC and Khrangana PHC show NC and HS frequently ranked in the top three, suggesting strong community interest in nutrition-related interventions and regular health check-ups as priorities. Environmental Health (EH) and Addiction (Add) are generally ranked lower, particularly in villages like Bogaon Nandora and Dorali, where EH appears among the last three rankings. This might reflect either a lower perceived immediacy of environmental factors in preconception health or limited community awareness of how environmental issues impact maternal and child health. Similarly, addiction receives varied attention, with certain villages like Mandavgad ranking it as low as ninth or tenth, highlighting differing community attitudes or levels of concern toward substance use in the preconception phase. Genetic Conditions (GC) and Mental Health (MH) rank in mid-level positions in several villages, indicating moderate awareness and concern. Karanji Kaji ranks GC and MH as fourth and fifth, respectively, showing some prioritization. This positioning could imply an understanding of genetic and mental health’s roles in family health but perhaps less urgency compared to other categories. The comparison to the WHO-recommended PCC packages with our study reveals additional locally prioritized areas that enrich the traditional scope of preconception care, reflecting specific community needs. Health Screening (HS) emerged as a unique package, encompassing checks for conditions such as diabetes, hypertension, thyroid disorders, and general blood testing, beyond the WHO’s focus on preventing disease transmission. This inclusion highlights the community's proactive stance on identifying and managing non-communicable diseases (NCDs) before pregnancy, a perspective aligned with the growing importance of NCD prevention in maternal and child health. Family Wellbeing (FW) , emphasizes family dynamics, social support, and education for young women (Kishori), touching on family planning education, child spacing, and reducing stigma around reproductive health. This package reflects the role of extended family in health decisions and the community's cultural understanding that reproductive health involves family and societal structures. The community’s emphasis on family wellbeing suggests a culturally sensitive approach that values collective support as integral to a woman’s health journey. While Lifestyle modification (Lm) package marks a proactive approach to physical wellness, with a focus on exercise promotion, community-based physical activity programs, and overall quality of life enhancement. Unlike WHO’s emphasis on the cessation of harmful substances, this package underscores the community's belief in positive lifestyle changes, recognizing exercise as a preventative measure that prepares individuals for a healthy pregnancy. The attention to physical well-being highlights the importance of quality of life in the preconception phase, resonating with an evolving understanding of holistic health. In our study, we integrated tobacco use and psychoactive substance use from the WHO package into a cohesive Addiction (Add) package, which incorporate the comprehensive approach to addiction prevention and treatment. This reflects a nuanced understanding of addiction, advocating for both health education and rehabilitation resources at the community level. The presence of this package signifies an awareness of addiction as a condition that requires support rather than solely a behavior to avoid. The final consensus on retaining specific PCC packages as shown in the Figure 2, was achieved through collaborative decision-making involving the Technical Advisory Group (senior public health professionals, health administration members, obstetricians, gynecologists, and researchers with experience in PCC). Discussion The community in this study showed a basic understanding of the benefits of PCC, such as better maternal and child health, safer deliveries, and the importance of pre-pregnancy care. However, many participants lacked awareness of specific services like genetic screening or early disease detection. For example, the limited understanding of genetic screening and early disease detection aligns with observations by Singh H et al. [10] who noted that a lack of knowledge about genetic risks is a barrier to PCC adoption. Cultural factors, such as the preference for male children, continue to influence reproductive decisions, a pattern similarly reported in the Indian context, where gender norms often shape healthcare-seeking behaviors[10,11]. Similar findings were reported by Doke et al.,[12] who noted that rural populations often struggle with misconceptions and limited knowledge about PCC. These findings suggest the need for targeted educational interventions to address these knowledge gaps, as noted in educational initiatives about PCC awareness that emphasize community-tailored strategies to foster understanding and uptake [13–15]. The community demonstrated a willingness to contribute to PCC, both financially and through active participation in clinic management. This finding resonates with the task-shifting approaches described by Deller et al., [16] where community health workers and other local actors played pivotal roles in promoting maternal and newborn health services in resource-limited settings. These findings echo recommendations by Chutke et al. [17] and Nomita Chandhiok et. al., [11] who emphasized using local networks and health workers to deliver PCC in rural areas. However, the varying levels of financial contributions reported in this study suggest the need for flexible and inclusive funding mechanisms to ensure equitable access. This aligns with previous findings that emphasize the need for sustainable models combining community involvement with external support [11,16]. This resonates with findings from Ojifinni et al.,[18] where high costs and logistical issues were major barriers to PCC adoption in low-resource settings. Current study underscores the gaps in awareness and access to PCC services, pointing to the need for better integration of PCC within existing healthcare frameworks, similar findings are shown by Annadurai K. et. al. [19] and Kolhe R et al. [9]. The community expressed a strong need for comprehensive PCC services, including essential health tests (e.g., blood tests, genetic screening), counseling on family planning, and education on healthy pregnancies. There was a particular focus on addressing non-communicable diseases (NCDs) like diabetes and hypertension, which reflects the growing recognition of their impact on maternal health. This aligns with Ebrahim et al., [20] who highlighted the importance of integrating preventive care, such as NCD management, into PCC programs. Additionally, the emphasis on family wellbeing and targeted education for adolescent girls (Kishori) underscores the need for culturally sensitive interventions that prepare young women for healthy motherhood. Our findings align with many of the PCC elements recommended by WHO, but they also reveal additional priorities specific to the local context. For example, while WHO emphasizes preventing disease transmission, the community in this study prioritized Health Screening and Family Wellbeing as critical components of PCC. Health Screening emerged as a key package, addressing conditions like diabetes, hypertension, and thyroid disorders, which are not prominently highlighted in WHO’s guidelines. Similarly, the focus on family wellbeing, covering family dynamics, child spacing, and reducing stigma around reproductive health, adds a unique cultural dimension to PCC implementation [21,22]. These locally enriched priorities highlight the importance of adapting global recommendations to meet the specific needs of the community. One of the significant challenges identified in this study was the heavy workload on healthcare providers, which limits their ability to deliver PCC effectively. To address this, the study suggests task-shifting strategies, such as involving trained nurses to manage PCC clinics, which align with the findings by Nomita Chandhiok et al. [11] and Deller B. et al [16]. Similar approaches have been successful in countries like Hong Kong and South Korea, where nurses and midwives play a central role in delivering PCC [20,23]. However, for such strategies to succeed, there must be adequate training, supportive policies, and consistent resources to sustain these initiatives over time. According to few studies Michael P. Daly et al. [23], Yatin V. Pimple et al. [24] and Narendra A. et al. [25] challenges such as poor compliance, low awareness, and weak program monitoring must be tackled to integrate PCC into India's healthcare system, particularly to achieve Sustainable Development Goals by 2030 which aligns with the finding of the current study. The findings of study by Nada Fussi et al. [26] and Rucha D. Phalke et al. [27] highlight a need for structured training programs to enhance awareness and practice among healthcare workers. Conclusions This formative research provides valuable insights into the community's understanding, contributions, and expectations regarding preconception care (PCC). While the community recognizes the benefits of PCC, such as improved maternal and child health, safer deliveries, and inter-conception care, there remain significant gaps in awareness of key aspects like genetic screening, early disease detection, and self-care practices. The community demonstrated strong support for PCC clinics, with a willingness to contribute financially and manage clinics through local figures like ASHA workers, self-help groups, and educated youth. Preferred locations for clinics included Gram Panchayat offices, Anganwadi centers, and primary healthcare facilities, reflecting the community’s emphasis on accessibility and convenience. The comparison with WHO-recommended PCC packages reveals additional locally prioritized areas that address specific community needs. Health Screening emerged as a key package, and Family Wellbeing package highlights the importance of family dynamics, social support, and education for young women, reflecting the cultural significance of collective decision-making in reproductive health. Lifestyle Modification and Addiction package, these community-driven priorities enrich the traditional scope of PCC, emphasizing holistic, culturally sensitive strategies for maternal and child health. The current study highlights the community's readiness to adopt PCC, provided services are affordable, accessible, and aligned with local priorities. By leveraging existing community networks and addressing gaps in awareness and healthcare delivery, PCC can be effectively integrated into existing healthcare frameworks to ensure better maternal and child health outcomes. Limitation of the Study The study's reliance on qualitative methods, while rich in detail, limits its generalizability to other regions or populations. Variations in awareness and prioritization among villages suggest heterogeneity that may not fully represent all community perspectives. Economic concerns raised by participants highlight potential challenges in implementing proposed PCC services, particularly regarding affordability and accessibility for underprivileged groups. Recommendation of the study Direct quotes enrich the findings, offering a nuanced understanding of community needs. The comparison with WHO-recommended PCC packages highlights locally prioritized areas such as Health Screening, Family Wellbeing, and Lifestyle Modification, reflecting a community-driven approach. The focus on trans-generational health issues and readiness for financial and logistical support demonstrates strong community engagement and cultural adaptability, making the results practical and actionable. Declarations Funding This study (Proposal ID- IIRP-2023-7250) and (File No: EMTR/SG/DEL/03/5 dated 21 Dec 2023) is being by funded the Indian Council of Medical Research (ICMR). Authors’ contributions The contributions of the authors to this work are as follows: AVR was responsible for conceptualization, designing the work, project administration, visualization, and writing – review and editing. KM and MG contributed to data curation, formal analysis, and drafting the original manuscript. SM carried out formal analysis, visualization, and drafting of the original manuscript. PV and SSG were involved in funding acquisition, while RJP and SJ managed project administration. BSG contributed to both funding acquisition and project administration. All authors have reviewed and approved the final manuscript. They have agreed to be personally accountable for their individual contributions and to ensure that any questions regarding the accuracy or integrity of any part of the work, including areas outside their direct involvement, are thoroughly investigated, appropriately resolved, and documented in the literature. Acknowledgements: Our heartfelt gratitude to all the participants who generously shared their valuable time, insights, and experiences, enabling us to delve deeper into the community's perceptions, preparedness, and expectations regarding preconception care. We are especially thankful to the community health workers, ASHAs, ANMs, and local governing bodies for their support and collaboration during the study. Our sincere appreciation goes to the research team for their unwavering dedication and efforts in conducting this formative research. We also extend our gratitude to Mr. Dinesh for his invaluable assistance in creating our research-based comprehensive Preconception Care (PCC) package. Availability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. References Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J et al (2014) Global causes of maternal death: A WHO systematic analysis. Lancet Glob Health. ;2(6) Hemsing N, Greaves L, Poole N (2017) Preconception health care interventions: A scoping review. Sexual and Reproductive Healthcare, vol 14. Elsevier B.V., pp 24–32 World Health Organization Headquarters Meeting to Develop a Global Consensus on Preconception Care to Reduce Maternal and Childhood Mortality and Morbidity [Internet]. Geneva; 2012 Feb [cited 2024 Dec 27]. Available from: https://iris.who.int/handle/10665/78067 Khekade H, Potdukhe A, Taksande AB, Wanjari MB, Yelne S (2023) Preconception Care: A Strategic Intervention for the Prevention of Neonatal and Birth Disorders. Cureus. ;15(6) Poix S, Elmusharaf K (2023) Investigating the pathways from preconception care to preventing maternal, perinatal and child mortality: A scoping review and causal loop diagram. Preventive Medicine Reports, vol 34. Elsevier Inc. National Rural Health Mission (2013) Guidelines for Community Processes. Ministry of Health and Family Welfare (MOHFW). Government of India. editor. New Delhi, p 84 Ministry of Health and Family Welfare (MOHFW) Government of India. Handbook for Members of Village Health Sanitation and Nutrition Committee [Internet]. Ms. Sulakhshana Nandi (Member National ASHA Mentoring Group) and Dr. T. Sundararaman (Executive Director NHSRC, editor. New Delhi: National Health Systems Resource Centre (NHSRC); 2015 [cited 2024 Dec 27]. 35 p. Available from: https://nhm.gov.in/images/pdf/communitisation/vhsnc/Resources/Handbook_for_Members_of_VHSNC-English.pdf World Health Organization Maternal mortality [Internet]. 2024 Apr [cited 2024 Dec 27]. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality Kolhe RS (2023) Optimizing Health Before Pregnancy: Evaluating the Feasibility of Community-Based Preconception Care Package in Rural Central India. Global Implement Res Appl 4:24–39 Singh H, Nair M, Kariya P, Bhatt S, Janardhanan D, Lakshmi Shanthi B et al Indian Academy of Pediatrics Consensus Guidelines on Preconception Care. Blooming Buds Child and Adolescent Care Centre. 12 Chandhiok N, Joglekar N, Shrotri A, Choudhury P, Chaudhury N, Singha S (2015) Task-shifting challenges for provision of skilled birth attendance: A qualitative exploration. Int Health 7(3):195–203 Doke PP, Gothankar JS, Pore PD, Palkar SH, Chutke AP, Patil AV et al (2021) Meager Perception of Preconception Care Among Women Desiring Pregnancy in Rural Areas: A Qualitative Study Using Focus Group Discussions. Front Public Health. ;9 Dhakal K (2016) Educational Intervention about Awareness of Preconceptional care: on Impact Among Bachelor Students. J Inst Med Nepal (JIOMN) 38(1):76–80 Anna James J, Sara George L, Fernandes S (2019) Preconception Care: Existing Knowledge in Karnataka, India and Need for an Intervention Article information Original Research. Women Health Open J 5(1):12–15 Schoenaker D, Gafari O, Taylor E, Hall J, Barker C, Jones B et al (2024) What Does ‘Preconception Health’ Mean to People? A Public Consultation on Awareness and Use of Language. Health Expect. ;27(4) Deller B, Tripathi V, Stender S, Otolorin E, Johnson P, Carr C (2015) Task shifting in maternal and newborn health care: Key components from policy to implementation. Int J Gynecol Obstet 130(S2):S25–31 Chutke APDPGJPPPSPADABKKM and SA. Perceptions of and challenges faced by primary healthcare workers about preconception services in rural India: A qualitative study using focus group discussion. Available from: Ojifinni OO, Ibisomi L (2019) Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study [Internet]. Available from: https://www.researchsquare.com/article/rs-4580/v2 Annadurai K, Mani G, Danasekaran R (2017) Preconception care: A pragmatic approach for planned pregnancy. Journal of Research in Medical Sciences, vol 22. Isfahan University of Medical Sciences(IUMS) Ebrahim SH, Lo SST, Zhuo J, Han JY, Delvoye P, Zhu L (2006) Models of preconception care implementation in selected countries. Matern Child Health J 10(1):37–42 Poels M, Koster MPH, Franx A, van Stel HF (2017) Parental perspectives on the awareness and delivery of preconception care. BMC Pregnancy Childbirth. ;17(1) Lassi ZS, Dean SV, Mallick D, Bhutta ZA (2014) Preconception care: delivery strategies and packages for care [Internet]. Available from: http://www.reproductive-health-journal.com/content/11/S3/S7 Daly MP, White J, Sanders J, Kipping RR (2022) Women’s knowledge, attitudes and views of preconception health and intervention delivery methods: a cross-sectional survey. BMC Pregnancy Childbirth. ;22(1) Pimple Y, Ashturkar M (2016) Preconception care: an Indian context. Int J Community Med Public Health. ;3291–3296 Narendra AR, Kowlgi A, Patil GH, Kar NS (2023) A. The why, what and how of preconception care: an exploratory descriptive qualitative study in Karnataka, India. Archives Public Health. ;81(1) Fussi N, Mandoura N (2023) Perceptions and Beliefs About Preconceptional Care Among Primary Healthcare Workers in Jeddah City, Saudi Arabia: An Analytical Cross-Sectional Study. Cureus Phalke RD, Patil RT, Jain P, Patil PS, Ambekar HG, Phalke VD (2023) Study of pre-conception care (PCC) amongst women in the first trimester coming to the obstetrics and gynaecology (OBGY) outpatient department (OPD) of a hospital in a rural area. J Family Med Prim Care 12(9):1879–1884 Tables Table 1 Community Perceptions of PCC: Thematic Insights from FGDs & IDIs Second order-Category First order Verbatim Inter-conception care Spacing between children MF1-P5 says that “there should be knowledge of spacing between two kids”. Gender norm Gender preference IDI-17 says that “if boy child is born then expect for girl child and vice versa, but in most of cases boy child is expected”. IDI-6 says that “people check girl or by during pregnancy, but people prefer boy child and because of boy child choice number of girl child is reduced”. FF4-P5 says that “everyone keep first pregnancy if they have two girl child, then they think of boy child and take one more attempt”. PCC benefits early detection of diseases, good for mother and baby, healthy pregnancy, safe and healthy delivery, transportation money will be saved if PCC clinic is available at village level FF7-P4 says “PCC will help us to know about sickle cell if it is there in mother” MF3-P1 says that “checkup and investigations will help to detect any problem which is already existing prior pregnancy”. MF3-P1 says that “PCC will help to avoid death during ANC and PNC”. FF5-P6 “period of care to treat trans-generational disease is before conception. Views on PCC Usually, people don’t think about PCC but should think, care should be taken before conception, healthy food items should be included in the meal, care has to be taken before 1–2 years or six months before. IDI-23 gives views on PCC “first of all it is necessary to explain it to all women, they will not say no, because whatever you said me earlier about PCC, I found this topic new, I liked this topic, this topic is new every time, I have never heard about this topic”. MF3-P4 says that “care should be taken before conception otherwise it will harm baby” MF3-P1 says that PCC will help to avoid abortion and it will save money too”. MF3-P1 says that “prior treatment can be taken and plan can be made for healthy Pregnancy”. MF1-P7 says that “before pregnancy AIDS test can be done and treatment can be taken”. FF8- P1, P2, P3, P4 says that “before conception treatment can be done which is good”, FF8-P1 says “to avoid miscarriage PCC is important” IDI-14 says that “before conception care and treatment is needed, if mother takes medicine, then baby can be safe”. FF4-P1 says that” after marriage people should know about their health status then only pregnancy should be planned”. Before pregnancy blood test HIV, couple test, BP, sugar, treatment, genetic test, vaccine should be taken, sickle cell, TB, asthma FF5-P6 says that “to have healthy baby pregnancy should be planned. To have healthy baby and healthy mother PCC vaccine, and PCC tests are essential”. FF2-P1 says that “before conception if blood test is done then it is good”. Period of care for trans-generational diseases before conception shall seek required treatment, if necessary, treatment should be taken 1–2 years before conception FF4-P5 says “the measures for trans-generational diseases can include male test and female test then treatment can be done before conception” FF4-P1 says that “previous test can be done before conception if any doubts of having any genetic disorder, we come to know through blood test reports, proper treatment can be taken to prevent from trans-generational disease, if we know about low HB earlier then required treatment can be done and baby can be safe and disease will not transfer to baby and in case trans-generational disease test done before pregnancy will let us know about mother's and father's health status so, after marriage people should know about their health status then only pregnancy should be planned”. FF3-P5 says that “before planning for pregnancy father shall undergo treatment for genetic disorder” Acceptance of PCC clinic most of the villages are showing their desire for PCC clinic in village, but the villages where there are PHC and other health centres are least interested. FF2-P1, P2, P3, P6 says that “there is a need of PCC clinic in village”. IDI-16 says that “there is biggest need of PCC clinic in this village as this village is 12 kms far away from the district”. IDI-14 says that “it is good concept on village level we will get clinic and there is no need of going outside the village”. IDI-1 “female can come doubtful about men visit to PCC clinic”. PCC perception on trans-generational diseases Detecting genetic disorder before conception and treating it will save baby from getting infected from disease. FF4-P4 says that “discuss with doctor about previous medical history then doctor will give treatment so that baby will be safe” IDI-16 says that “hereditary diseases can be controlled prior pregnancy by taking vaccine for 1–3 years”. Role of Asha towards Kishori Asha guide Kishori regarding self-care and HB maintenance. Kishori are the future would be mothers IDI-2 “there is a need to well educate adolescent girls towards their health, because in future they are going to get married and bear children so…” Self-care before conception disease free mother, healthy balanced diet, exercise, proper weight and height, free environment and stress free. IDI-15 says that ‘it is good to do test before conception but no one does it, but after conception it becomes mandatory then women do all the treatment”. Perception about PCC fees on charging fees may be most of them will avoid to come to clinic, minimal fee is expected. IDI- “5 Rs will do”. IDI-1 “10–20 Rs”. FF2-P6 says that “30 − 20 Rs anyone can give”. FF3-P3 says that “it should be of free of cost”. FF7- P1 says that “I think 5–10 Rs”. MF4- P1 says that “10 Rs”. Table 2 Contributions to Preconception Care: A Thematic Review from FGDs & IDIs Second order-category First order Verbatim Management responsibility Asha, self-help group, retired personnel, bachatgut members, male preference and Gram Sangh female preference in management. Responsibility IDI-23 “2–3 women are there, those are Gram Sangh’s president and secretary, we can give to such people”. IDI-5 says that “any people can help in management”. IDI-4 says that “those who are interested can take management responsibility” IDI-9 says that “any educated boy from village can take the responsibility of clinic management”. Promotion Women, Asha bachatgut females, ladies group discussion, normal meetings, survey, mouth publicity, whats app can be used for promotion, Gram Panchayat dawandi, meetings in Anganwadi and subcentres and Anganwadi Sevika can promote PCC. FF3-P7 “women in village can share information regarding PCC clinic” FF4-P5 “bachatgut females can help”. IDI-23 “In Sangh meeting, we can tell them we want to open PCC clinic, we can ask them what is their opinion they will say we have clinic in our village, we don’t feel PCC clinic’s need. Then we can ask them whether they undergo PCC treatment in those clinic, then they will say no, then madam you can proceed with your part of explaining them about PCC”. IDI-3 says that “ regarding PCC clinic, announcement can be done in village through dawandi”. IDI-2 “people meet in field while their works they will discuss about PCC clinic”. IDI-7 says that “during mata sabha information can be given to women about PCC clinic in our village”. Money contribution 50,100, 200, 300, 500, 1000, people can contribute as per their economic status. MF4-P5 says that “in general people can give 100–200 Rs”. IDI-23 “No, I can’t tell about others, I can tell about myself I can give 100 Rs/-’. Location of the clinic Gram Panchayat, Anganwadi, School, temple, or any vacant room available in village. IDI-23 “In Gram Panchayat one day clinic work can….similarly for our work they will provide, because we don’t have any other place. We don’t have office for Gram Sangh meetings, we conduct our meetings here and there, if we would have our office then we would have provide it for one day of your clinic work, that place would be of my right, no one else would have oppose it”. MF5- P8 says that “If we think of gram panchayat then will have to take permission. P6 - says that Gram Panchayat is one of the places where everyone can gather”. MF5- P7 says that “you explain your concept to sarpanch, they may help for clinic place in village”. IDI-3 says that “it can be government hospital”. IDI-11 says that “PHC, two rooms are available at PHC”. Table 3 Expectations for PCC Services: Thematic Findings from FGDs & IDIs Second order-category First order Verbatim Facility expectation: test expectation Blood test, vaccine, weighing machine, sonography, medicine availability, urine test, in emergency cases doctors should be available, treatment on infertility, service expectation, ambulance availability, Bp, sugar, thyroid, asthma, blood test, urine test, fever, HIV, AIDS, TB, Pneumonia, typhoid, cough and cold and sickle cell test, medication and nutrition supplement expectation. FF2-P1 and P5 says that” everything is needed like nutrition supplement, protein powder, milk and banana, vaccine which is given prior pregnancy”. IDI-4 says that “service should be free and it will be helpful for BPL people those can’t afford greens and rich food”. Counselling expectation family counselling, couple counselling, counselling on safe and hygiene pregnancy and life style, counselling on addictions, counselling on infertility, counselling on mother care, counselling on safety in pregnancy, counselling on cleanliness, counselling expectation on baby planning and family planning methods, male counselling expectation, paediatric clinic expectation, counselling on inter-space between two kids, counselling on newly weds, counselling on medicines side effects on health during pregnancy MF1-P5 says that “there should be counselling on space between two kids” MF1-P6 says that “there should be counselling on family planning methods and how to conceive?” MF1-P6 says that “counselling for newly married couple is required”. MF1-P1 says that “counselling on male female infection care” FF4-P5 says that “family counselling especially for in-laws” Case paper fee 5, 10, 20, 100, 200, 500, free of cost, less fee is expected MF-P4 says that “below poverty line should be able to pay 20 Rs”. MF-P7 says that “there are financially weak people for them 20 Rs is more then if we keep 10 Rs then more people can come”. MF- P6 says that “ according to financial status anyone can give 30 Rs”. Treatment expectation male treatment expectation, treatment on oligohydramnios, mental health treatment, advice by senior doctors. FF4-P5 says that “there should be treatment after abortion”. Facility expectation for Kishori kishori are the would-be mothers so they should be properly educated towards their health care. IDI-2 “there is a need to well educate adolescent girls towards their health, because in future they are going to get married and bear children so…” Education on health Education on health care, promotion expectation from nurse. MF1-P1 says that “methods of family planning related information and education is needed”. IDI − 12 says that “information related health should be given to people through enjoyment and entertainment”. IDI-2 says that “yes counselling is important and if necessary, information is provided then many people will come to clinic”. Human resource female doctor, male doctor, gynaecologist and Nurse FF3-P3 says that “in emergency cases doctors should be available” MF5-P5 says that “ male and female doctor both are required”. IDI-3 says that “……. yes, but for first visit doctor is needed later on Nurse can be managed. Once nurse is introduced to villagers it will work”. Table 4 Expectations for PCC: Insights from Free Listing and Ranking Analysis PHC Village Facility expectation NC VPDs GC EH Inf MH Cont IV Add HS FW Lm Anji Bogaon Nandora 2 7 3 8 5 6 4 12 9 1 11 10 Anji Karanji Kaji 2 11 4 12 9 5 3 10 7 1 6 8 Anji Narsula 4 8 7 12 3 6 5 11 9 1 2 10 Anji Borgaon Sawali 1 8 3 11 5 10 4 12 9 2 6 7 Anji Chaka 4 10 8 12 3 7 5 11 9 2 1 6 Khrangana Karla 1 6 5 11 3 7 2 12 8 4 9 10 Khrangana Kutki 3 8 4 12 7 10 6 9 11 1 2 5 Khrangana Nandora 3 5 4 8 6 7 2 10 9 1 12 11 Khrangana Dhanora 4 7 1 8 6 12 5 10 11 2 3 9 Khrangana Mandavgad 2 3 8 5 6 9 7 12 11 4 10 1 Talegaon Seloo Kate 1 7 5 10 3 11 4 12 9 2 6 8 Talegaon Neri (Mirapur) 4 3 2 9 5 11 6 12 10 1 8 9 Talegaon Inzapur 1 8 7 12 4 9 3 10 11 2 5 6 Talegaon Bhivapur 2 7 1 8 4 12 5 11 10 3 9 6 Talegaon Aastha 2 3 7 10 6 8 4 9 11 1 12 5 Waifad Nagthana 5 4 2 12 7 10 3 11 9 1 6 8 Waifad Lonsowali 3 11 10 12 9 8 5 6 4 2 7 1 Waifad Dorali 2 5 3 12 6 11 7 10 8 1 9 4 Waifad Dhamangaon 2 5 7 10 4 8 3 11 12 1 9 6 Waifad Chikni 1 7 2 12 6 4 5 9 3 8 10 11 NC: Nutritional Conditions, VPDs: Vaccine Preventable Disease, GC: Genetic Conditions, EH: Environmental Health, Inf: Infertility/ Subfertility, MH: Mental Health, FW: Family Wellbeing, IV: Interpersonal violence, Add: Addiction, HS: Health Screening, Cont: Family welfare, Lm: Lifestyle Modification Additional Declarations The authors declare no competing interests. Supplementary Files 8.supplementarymaterial.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5749029","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":396588437,"identity":"dafdcb28-9899-4b5d-9e4f-9b98c3fded41","order_by":0,"name":"Swati Misra","email":"","orcid":"https://orcid.org/0000-0003-1020-1239","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India","correspondingAuthor":false,"prefix":"","firstName":"Swati","middleName":"","lastName":"Misra","suffix":""},{"id":396588438,"identity":"8c0fb867-6edb-40e4-809e-1b549dba21f5","order_by":1,"name":"Kamlesh Mahajan","email":"","orcid":"https://orcid.org/0000-0003-0423-0500","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India","correspondingAuthor":false,"prefix":"","firstName":"Kamlesh","middleName":"","lastName":"Mahajan","suffix":""},{"id":396588439,"identity":"bcc9b759-9936-44dc-a0be-a22b67d21759","order_by":2,"name":"Mohini Gawai","email":"","orcid":"https://orcid.org/0009-0008-6686-0878","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India","correspondingAuthor":false,"prefix":"","firstName":"Mohini","middleName":"","lastName":"Gawai","suffix":""},{"id":396588440,"identity":"4a918545-bc34-47d1-b116-e715f54d4212","order_by":3,"name":"Abhishek V. Raut","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9klEQVRIiWNgGAWjYDACCR6GA4wNDAYQXgUQMzM3kKDlwBmQFkbCWhjgWg62gUgCWvhn9x48+HOHjbHB7cPPpD/Oq43mbwdq+VGxDbcld84lHOY9k2ZmcC7NTOLgtuO5Mw4zNjD2nLmN25obOQaHGdsO20j2MIC0HMttAGphZmzDrUUeqOXgz7b/QC3s3yQOzjmWO5+QFgOglgO8bQfM+Hl4gLY01ORuIKTF8M4Zg8O8bcnGQC3FFmeOHcjdCNRyEJ9f5G73GH/82WZn2MbDvvFGRU1d7rzzhw8++FGBx/to4DCYPEC0eiCoI0XxKBgFo2AUjBAAAJd4YRXWi8BNAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0001-5671-5329","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India","correspondingAuthor":true,"prefix":"","firstName":"Abhishek","middleName":"V.","lastName":"Raut","suffix":""},{"id":396588441,"identity":"754a21f2-3c98-4527-857e-4d0e0c6cf27a","order_by":4,"name":"Poonam Varma","email":"","orcid":"https://orcid.org/0000-0002-4699-4296","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India","correspondingAuthor":false,"prefix":"","firstName":"Poonam","middleName":"","lastName":"Varma","suffix":""},{"id":396588442,"identity":"0695af78-ede4-4c9c-867c-b9b6f5817879","order_by":5,"name":"R. J. Paradkar","email":"","orcid":"https://orcid.org/0000-0002-4055-7386","institution":"District Health Office, Zilla Parishad, Wardha, India","correspondingAuthor":false,"prefix":"","firstName":"R.","middleName":"J.","lastName":"Paradkar","suffix":""},{"id":396588443,"identity":"2bff653d-c82e-447c-b912-6c79d1610003","order_by":6,"name":"Shuchi Jain","email":"","orcid":"https://orcid.org/0000-0002-9614-3430","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India","correspondingAuthor":false,"prefix":"","firstName":"Shuchi","middleName":"","lastName":"Jain","suffix":""},{"id":396588444,"identity":"8a7104e0-6ecd-4ea7-bf50-b7c9a6da0b6c","order_by":7,"name":"Subodh S. Gupta","email":"","orcid":"https://orcid.org/0000-0002-4412-9389","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India","correspondingAuthor":false,"prefix":"","firstName":"Subodh","middleName":"S.","lastName":"Gupta","suffix":""},{"id":396588445,"identity":"3300a36c-e2bb-461a-883e-62e283707b92","order_by":8,"name":"B. S. Garg","email":"","orcid":"https://orcid.org/0000-0003-1179-0776","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India","correspondingAuthor":false,"prefix":"","firstName":"B.","middleName":"S.","lastName":"Garg","suffix":""}],"badges":[],"createdAt":"2025-01-02 05:46:47","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":true,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5749029/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5749029/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":73077620,"identity":"46174acb-6390-4b7f-b332-e62293ad2201","added_by":"auto","created_at":"2025-01-06 13:42:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":91463,"visible":true,"origin":"","legend":"\u003cp\u003eBarrier, Perceptions, and Benefits of Preconception Care (PCC): A Community-Based Mind Map\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-5749029/v1/b3aef739f64efb557d824b23.png"},{"id":73077624,"identity":"159a6787-84c9-4538-b840-d79bc336bd94","added_by":"auto","created_at":"2025-01-06 13:42:44","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":603103,"visible":true,"origin":"","legend":"\u003cp\u003eResearch-Based Comprehensive Preconception Care Packages\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-5749029/v1/8a2c99ef451ca17978bdbe16.png"},{"id":73079483,"identity":"7636c616-43d0-49cb-872c-ec443267fd5f","added_by":"auto","created_at":"2025-01-06 13:58:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1743381,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5749029/v1/9e12775d-d7f2-4f68-a329-e9e32414e298.pdf"},{"id":73077619,"identity":"2318ff1e-f7f0-41d8-86ce-7d1fb10518cd","added_by":"auto","created_at":"2025-01-06 13:42:44","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":37956,"visible":true,"origin":"","legend":"","description":"","filename":"8.supplementarymaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-5749029/v1/21c4cde6a5fb8a67794c2906.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eUnderstanding Community Perceptions, Preparedness, and Expectations of Preconception Care: A Formative Research Approach\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eOver the years, advancements in antenatal care have significantly reduced maternal and neonatal mortality. Yet, despite these improvements, an estimated 800 women and 6,700 newborns continue to die daily from preventable complications related to pregnancy and childbirth. The burden of these deaths is disproportionately high in low- and middle-income countries, where unplanned pregnancies, preterm births, birth defects, complications during labor, and infections are the primary contributing factors [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Globally, half of maternal deaths are attributed to just three causes: haemorrhage, hypertensive disorders, and sepsis [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Relying solely on antenatal care has proven to be insufficient, as it fails to address health issues that emerge before or in the early weeks of pregnancy. In low-resource settings, the first antenatal visit often occurs too late to detect and manage problems that contribute to maternal and neonatal mortality and morbidity. This highlights the need for earlier interventions and comprehensive care strategies to improve outcomes [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e\n\u003ch3\u003eRole of Preconception Care in Improving Health Outcomes\u003c/h3\u003e\n\u003cp\u003eMuch of the maternal and neonatal mortality and morbidity has its roots in the preconception period. Therefore, providing care before pregnancy, known as preconception care (PCC), is crucial in preventing maternal and child mortality and morbidity. Preconception care involves a set of interventions offered to women and couples before conception, aiming to improve and promote favorable neonatal and birth outcomes. By identifying and addressing modifiable risks to maternal and fetal health, it leverages social, behavioral, and medical interventions to optimize health before pregnancy [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Preconception care has the potential to significantly improve maternal and child health outcomes. Recognizing this, the WHO has developed a comprehensive preconception care package that covers 13 key areas. The WHO strongly recommends its global implementation to address critical health needs before pregnancy [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eChallenges and Opportunities for Preconception Care in India\u003c/h2\u003e \u003cp\u003eCurrently, India lacks a dedicated public health program for providing regular PCC services, with existing interventions scattered across various policies. The delivery of PCC interventions faces challenges due to the absence of specific socio-cultural guidelines, limited understanding of community needs, lack of awareness, and resource constraints among healthcare providers. This formative research aims to address these gaps by enhancing the understanding of these factors. It forms part of a stepped-wedge cluster randomized implementation trial that will assess the impact of a community-based preconception care package, delivered by trained nurses, on preconception health, maternal health, and child health outcomes. It is recognized that government healthcare facility doctors will have limited involvement in delivering PCC to the community, as they are already burdened with providing curative and preventive services. To address this, a task-shifting strategy has been implemented, where trained nurses take on the responsibility of delivering PCC services [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis study aims to explore the community's acceptance of nurses in delivering preconception care (PCC) services, assess the efficiency of nurses in providing the PCC package, and understand community perceptions, preparedness, and expectations regarding PCC. Additionally, it will determine the community's readiness to engage with PCC services if made available at the village level. A key focus of the study is to co-develop a comprehensive PCC package in consultation with the community, ensuring it addresses their specific needs and encourages active contribution toward improving maternal and child health outcomes.\u003c/p\u003e \u003c/div\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Methods\u003c/h2\u003e \u003cp\u003eThis formative research was conducted using a qualitative approach to assess community perceptions, preparedness, and expectations regarding PCC. It was conducted as part of a stepped-wedge cluster randomized implementation trial, with the goal of co-developing a community-based PCC package delivered by trained nurses. The research adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines, ensuring transparency, rigor, and a systematic approach throughout the study. The qualitative methods employed included focus group discussions (FGDs), in-depth interviews (IDIs), and free listing and ranking exercises. The fieldwork for this research was conducted between March to June 2024.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Settings\u003c/h3\u003e\n\u003cp\u003eThe study was conducted in 96 villages across four Primary Health Centres (PHCs) located in the Wardha Community Development Block of Maharashtra, India. These villages ranged in size, with populations between 300 and 10,000, covering a total population of approximately 120,000 people. Peri-urban villages within a 5-kilometer radius of Wardha town were excluded from the study to focus on rural community. The PHCs involved were:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePHC An: 28 villages\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePHC Kh (G): 25 villages\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePHC Ta (Wa): 25 villages\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePHC Wa: 26 villages\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e\n\u003ch3\u003eSample size, Participants and Sampling method\u003c/h3\u003e\n\u003cp\u003eThe sample size for this formative research was determined based on the need to gather diverse and comprehensive perspectives from different community members regarding preconception care (PCC). As the study utilized qualitative methods, it adhered to the principle of data saturation. Saturation was reached when no new information or themes emerged from the data collection, ensuring that the sample was sufficient to meet the study's objectives. \u003cb\u003eTable S1\u003c/b\u003e (Supplementary Material) provides a matrix outlining the data collection methods, their objectives, and the associated sample sizes. Participants were selected using purposive sampling based on the following eligibility criteria:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eEligible couples\u003c/b\u003e: Newly married couples planning for a baby or couples who already had one or more children and were planning for another child.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eKey informants\u003c/b\u003e: Village Representative like:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eSarpanch\u003c/b\u003e (Village Head),\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eGram Sabha members\u003c/b\u003e (Village Council members),\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eASHA workers\u003c/b\u003e (Community Health workers),\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eAnganwadi Sevika\u003c/b\u003e (Village Childcare workers),\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003ePolice Patil\u003c/b\u003e (Village Police representatives),\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eOther community members like \u003cb\u003eMale and Female CRP\u003c/b\u003e (Community Resource Person), \u003cb\u003ePRP\u003c/b\u003e (Panchayat Resource Person), and \u003cb\u003eBachat Gat members\u003c/b\u003e (Women Self-help group members).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eNon-Participants\u003c/b\u003e: Eligible couples with either partner using permanent contraception were excluded from the study.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Collection Process\u003c/h2\u003e \u003cp\u003eField techniques included establishing rapport with villagers through prior meetings, where the concept of PCC was thoroughly explained. It was also ensured that the village head was informed in advance about the purpose of the study to gain their support and involvement. Following these initial engagements, eligible couples were informed about the study and approached through their respective village representatives to encourage participation. Data collection methods were planned based on the population of the villages. In more densely populated villages with group gram panchayats, separate FGDs were conducted for men and women. In smaller villages, a combination of qualitative methods was used, but all key informants across the study area were approached for IDI. The initial step of the fieldwork involved conducting IDIs, which helped the team to understand the overall status of the village. This included gathering information on the number of eligible couples and the community's views on healthcare services, such as antenatal and postnatal care (ANC and PNC). The insights gained from these IDIs also helped in organizing participants for subsequent FGDs and Free Listing \u0026amp; Ranking exercises. The project team received training on qualitative data collection methods, and all data collection activities were conducted under the supervision of an anthropologist to ensure methodological rigor. The primary method of engagement with villagers and higher village authorities was face-to-face interaction, which allowed the team to build rapport. In some cases, telephonic conversations were used to facilitate further communication and coordination with village representatives. The profiles for male FGDs, female FGDs, and IDIs are detailed in the \u003cb\u003eTables S2\u0026ndash;S4\u003c/b\u003e (Supplementary Material).\u003c/p\u003e \u003cp\u003e Voice recordings of the interviews, lasting 30\u0026ndash;40 minutes, were taken, while sociograms and detailed field notes captured participant interactions and key observations during the sessions. Female FGDs were conducted during the day, with ASHA informing participants in advance. Data collection methods were held in various village locations, including Anganwadi centers, schools, temples, or participants' homes. Male FGDs, conducted in the evening, posed challenges due to the availability of participants, with frequent off-topic queries and cross-questions directed at female facilitators, making each session unique. For free listing and ranking, participants listed their expectations for the village PCC clinic on chart paper, with individual scores assigned based on the total number of expectations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe data collected from the FGDs, IDIs, and free listing \u0026amp; ranking exercises were analyzed using thematic content analysis. A mixed approach was used for data analysis. Initially, a deductive approach was applied, using predefined themes based on the research objectives, while remaining open to new themes that emerged inductively from the data. This combination allowed for structured analysis while accommodating the discovery of unexpected insights. The analysis followed a systematic approach to identify recurring themes and patterns in community perceptions, preparedness, and expectations regarding PCC.\u003c/p\u003e \u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eTranscription and Translation\u003c/b\u003e: Audio recordings from the FGDs and IDIs, conducted in the Marathi language, were transcribed verbatim by trained ANMs. These transcriptions, along with detailed field notes and sociograms, were reviewed by two independent researchers to ensure an in-depth understanding of the data. Familiarization with the data was achieved through repeated reading of the transcripts, which allowed the researchers to immerse themselves in the content.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eCoding\u003c/b\u003e: For the coding of the qualitative data, a manual approach was used with three coders to ensure consistency, accuracy, and inter-coder reliability throughout the analysis. Initial coding was conducted by two independent researchers, who reviewed the transcripts line by line, identifying key phrases, ideas, and recurring thoughts shared by the participants. The coding process involved identifying first-order codes, which were based on direct responses from participants. The codes represented recurring topics such as PCC Perceptions, PCC Contribution, PCC Expectation.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eDevelopment of Sub-themes and Themes\u003c/b\u003e: After the first-order codes were identified, the researchers grouped similar codes into second-order sub-themes. These sub-themes captured more specific aspects of the participants' views and experiences. The sub-themes were further consolidated into higher-order themes based on their conceptual similarity.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eConsensus and Validation\u003c/b\u003e: To ensure the reliability of the themes and sub-themes, the coding and thematic structure were discussed among the research team, including the Principal Investigator. Discrepancies in coding and theme identification were resolved through discussion until consensus was reached.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e \u003cp\u003e In addition to thematic analysis, a quantitative aspect was incorporated by calculating respondent frequency for each first-order code, indicating how many participants shared a specific view. This helped prioritize the most frequently mentioned and important themes. The final themes were refined and reviewed in collaboration with the Principal Investigator. This ensured that the themes accurately captured the key insights related to community readiness for PCC and addressed the study objectives. The finalized themes provided a comprehensive understanding of community perspectives, including their expectations from PCC services and the challenges they faced in accessing care.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eTriangulation\u003c/h3\u003e\n\u003cp\u003eTriangulation was employed in this study to enhance the validity and reliability of the findings by incorporating data from multiple qualitative methods\u0026mdash;FGDs, IDIs, and Free Listing \u0026amp; Ranking exercises. Methodological triangulation ensured that data collected through FGDs, which captured group perceptions, were cross-validated with insights from IDIs, providing detailed individual perspectives, and Free Listing \u0026amp; Ranking, which highlighted specific community expectations regarding PCC. Data source triangulation involved gathering information from diverse participants, including newly married couples, key informants like Sarpanch, ASHA workers, and Anganwadi Sevikas, and couples planning for another child, ensuring a comprehensive understanding of community views. Additionally, investigator triangulation was applied, with two independent researchers conducting the initial coding and thematic analysis, and any discrepancies being resolved through discussions with the Principal Investigator. This triangulation approach strengthened the study's conclusions by ensuring consistency and depth across multiple data sources and methods.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e for the research was obtained from the Institutional Ethics Committee (IEC) for Research on Human Subjects at MGIMS prior to the study's initiation, in accordance with IEC approval letter no. IEC/406/2023, dated 30 December 2023. Verbal informed consent was taken by each participant for their participation and audio recording.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe results of this formative research provide valuable insights into the community\u0026apos;s understanding and engagement with PCC. Emerged themes reflect the community\u0026rsquo;s perceptions of PCC, their contributions toward implementing PCC practices, and their expectations of such services. The findings are organized into distinct thematic categories, each illustrated with direct quotes from participants to highlight the perspectives shared. The analysis is presented in the following sections, detailing the core themes that have emerged from the data.\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eCommunity Perceptions of PCC: Thematic Insights from FGDs \u0026amp; IDIs\u003c/li\u003e\n \u003cli\u003eContributions to PCC: A Thematic Review from FGDs \u0026amp; IDIs\u003c/li\u003e\n \u003cli\u003eExpectations for PCC Services: Thematic Findings from FGDs \u0026amp; IDIs\u003c/li\u003e\n \u003cli\u003eExpectations for PCC: Insights from Free Listing and Ranking Analysis\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eFigure 1\u003c/strong\u003e outlines the barriers, perceptions, and benefits of Preconception Care (PCC) using a community-based mind map. The higher-order theme in \u003cstrong\u003eTable 1\u003c/strong\u003e is \u003cstrong\u003eCommunity Perceptions of PCC\u003c/strong\u003e. The table reveals that, while the community recognizes the advantages of PCC, there is still a significant lack of awareness, particularly regarding early disease detection, genetic screening, and preparing for a healthy pregnancy. Cultural norms, such as the strong preference for male children, persist and often influence reproductive decisions. Respondents emphasized the importance of inter-conception care, particularly the need for proper spacing between children to ensure adequate nutrition for both mother and child. They highlighted the benefits of PCC, including improved maternal and child health, safer deliveries, and the convenience of having a PCC clinic in the village, which would save time and money by providing timely care.\u003c/p\u003e\n\u003cp\u003eAdditionally, respondents stressed the importance of blood tests before conception, mentioning tests for HIV, blood pressure, sugar levels, genetic disorders, and vaccines like tetanus. There was also a focus on the period of care for trans-generational diseases, with many agreeing that treatment for genetic disorders should begin 1-2 years or at least six months before conception to ensure a healthy baby. Commonly discussed trans-generational diseases included blood pressure, diabetes, thyroid issues, and genetic conditions, all of which respondents believed should be treated before pregnancy.\u003c/p\u003e\n\u003cp\u003eWhile the community expressed a desire for PCC clinics, particularly in remote areas, concerns about affordability and accessibility were raised. Some participants suggested that fees should be minimal, as many struggle with paying taxes and may avoid attending the clinic if the costs are too high. In contrast, villages with existing healthcare centers showed less interest in new PCC services. The role of ASHA workers in educating adolescent girls (Kishori) was also emphasized, as they are the future mothers and often suffer from anemia. Finally, respondents highlighted the importance of self-care before conception, including regular health monitoring, genetic testing, a nutritious diet, and taking the necessary PCC vaccines. Couples should be aware of their own and their partner\u0026rsquo;s health status before planning a pregnancy. Overall, the community showed a readiness to adopt PCC but needs increased education, financial support, and accessible services to ensure successful implementation.\u003c/p\u003e\n\u003cp\u003eThe higher-order theme in \u003cstrong\u003eTable 2\u003c/strong\u003e is \u003cstrong\u003eContributions to Preconception Care\u003c/strong\u003e, which encompasses the community\u0026apos;s role in managing, promoting, and supporting the PCC clinic. The table reveals that management responsibility could be shared among various local figures, such as ASHA workers, self-help groups, bachatgut members, and even educated youth, demonstrating flexibility and inclusivity in leadership. Promotion of the PCC clinic is expected to rely heavily on grassroots efforts, including discussions during local meetings, women\u0026rsquo;s groups, ASHA workers, and informal platforms like WhatsApp groups. The community showed readiness to contribute financially, with suggested amounts ranging from INR 50/- to INR 1000/-, depending on individual economic capacity. This indicates a general willingness to support the clinic despite varying financial capabilities. Additionally, several potential locations for the clinic were identified, including Gram Panchayat offices, Anganwadi centers, schools, and even available rooms in PHCs or government hospitals. The need for coordination with local authorities, like the Sarpanch, was also emphasized. Overall, the analysis reflects strong community support for the PCC clinic, relying on local resources, networks, and leadership to ensure its success.\u003c/p\u003e\n\u003cp\u003eThe higher-order theme in \u003cstrong\u003eTable 3\u003c/strong\u003e is \u003cstrong\u003eExpectations for PCC Services,\u003c/strong\u003e which captures the community\u0026rsquo;s anticipated services and support from PCC clinics. The community expressed the need for a broad range of healthcare facilities, including essential tests like blood tests, sonography, vaccines, and emergency care, particularly for conditions like infertility, asthma, and chronic diseases. Additionally, there is a strong demand for counselling services, covering areas such as family planning, safe pregnancy practices, hygiene, spacing between children, and counselling for newlyweds and in-laws. Affordability is a crucial factor, with many participants advocating for low or no fees, particularly for those living below the poverty line. The community also highlighted the importance of providing targeted health education for adolescent girls (Kishori) to prepare them for future motherhood. Respondents emphasized the need for both male and female doctors, gynecologists, and nurses, especially during emergencies, with nurses managing ongoing care after the first visit. Overall, the community\u0026rsquo;s expectations reflect a desire for comprehensive, affordable, and accessible PCC services, emphasizing the importance of education, counselling, and full medical support.\u003c/p\u003e\n\u003cp\u003eThe \u003cstrong\u003eTable 4\u003c/strong\u003e presents the ranking exercise analysis of facility expectations for Preconception Care (PCC) across various villages serviced by different Primary Health Centers (PHCs) in the region. This free listing and ranking exercise provide insights into the relative prioritization of different PCC packages based on the needs and preferences expressed by the communities. \u003cstrong\u003eNutritional Conditions (NC)\u003c/strong\u003e and \u003cstrong\u003eHealth Screening (HS)\u003c/strong\u003e consistently rank high across most villages, indicating a widespread emphasis on basic health and nutrition as foundational to preconception care. Anji PHC and Khrangana PHC show NC and HS frequently ranked in the top three, suggesting strong community interest in nutrition-related interventions and regular health check-ups as priorities. \u003cstrong\u003eEnvironmental Health (EH)\u003c/strong\u003e and \u003cstrong\u003eAddiction (Add)\u003c/strong\u003e are generally ranked lower, particularly in villages like Bogaon Nandora and Dorali, where EH appears among the last three rankings. This might reflect either a lower perceived immediacy of environmental factors in preconception health or limited community awareness of how environmental issues impact maternal and child health. Similarly, addiction receives varied attention, with certain villages like Mandavgad ranking it as low as ninth or tenth, highlighting differing community attitudes or levels of concern toward substance use in the preconception phase. \u003cstrong\u003eGenetic Conditions (GC)\u003c/strong\u003e and \u003cstrong\u003eMental Health (MH)\u003c/strong\u003e rank in mid-level positions in several villages, indicating moderate awareness and concern. \u0026nbsp;Karanji Kaji ranks GC and MH as fourth and fifth, respectively, showing some prioritization. This positioning could imply an understanding of genetic and mental health\u0026rsquo;s roles in family health but perhaps less urgency compared to other categories.\u003c/p\u003e\n\u003cp\u003eThe comparison to the WHO-recommended PCC packages with our study reveals additional locally prioritized areas that enrich the traditional scope of preconception care, reflecting specific community needs. \u003cstrong\u003eHealth Screening (HS)\u003c/strong\u003e emerged as a unique package, encompassing checks for conditions such as diabetes, hypertension, thyroid disorders, and general blood testing, beyond the WHO\u0026rsquo;s focus on preventing disease transmission. This inclusion highlights the community\u0026apos;s proactive stance on identifying and managing non-communicable diseases (NCDs) before pregnancy, a perspective aligned with the growing importance of NCD prevention in maternal and child health. \u003cstrong\u003eFamily Wellbeing (FW)\u003c/strong\u003e, emphasizes family dynamics, social support, and education for young women (Kishori), touching on family planning education, child spacing, and reducing stigma around reproductive health. This package reflects the role of extended family in health decisions and the community\u0026apos;s cultural understanding that reproductive health involves family and societal structures. The community\u0026rsquo;s emphasis on family wellbeing suggests a culturally sensitive approach that values collective support as integral to a woman\u0026rsquo;s health journey. While \u003cstrong\u003eLifestyle modification (Lm)\u003c/strong\u003e package marks a proactive approach to physical wellness, with a focus on exercise promotion, community-based physical activity programs, and overall quality of life enhancement. Unlike WHO\u0026rsquo;s emphasis on the cessation of harmful substances, this package underscores the community\u0026apos;s belief in positive lifestyle changes, recognizing exercise as a preventative measure that prepares individuals for a healthy pregnancy. The attention to physical well-being highlights the importance of quality of life in the preconception phase, resonating with an evolving understanding of holistic health. In our study, we integrated tobacco use and psychoactive substance use from the WHO package into a cohesive \u003cstrong\u003eAddiction (Add)\u003c/strong\u003e package, which incorporate the comprehensive approach to addiction prevention and treatment. This reflects a nuanced understanding of addiction, advocating for both health education and rehabilitation resources at the community level. The presence of this package signifies an awareness of addiction as a condition that requires support rather than solely a behavior to avoid. The final consensus on retaining specific PCC packages as shown in the \u003cstrong\u003eFigure 2,\u003c/strong\u003e was achieved through collaborative decision-making involving the Technical Advisory Group (senior public health professionals, health administration members, obstetricians, gynecologists, and researchers with experience in PCC).\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe community in this study showed a basic understanding of the benefits of PCC, such as better maternal and child health, safer deliveries, and the importance of pre-pregnancy care. However, many participants lacked awareness of specific services like genetic screening or early disease detection. For example, the limited understanding of genetic screening and early disease detection aligns with observations by Singh H et al. [10] who noted that a lack of knowledge about genetic risks is a barrier to PCC adoption. Cultural factors, such as the preference for male children, continue to influence reproductive decisions, a pattern similarly reported in the Indian context, where gender norms often shape healthcare-seeking behaviors[10,11]. Similar findings were reported by Doke et al.,[12] who noted that rural populations often struggle with misconceptions and limited knowledge about PCC. These findings suggest the need for targeted educational interventions to address these knowledge gaps, as noted in educational initiatives about PCC awareness that emphasize community-tailored strategies to foster understanding and uptake [13\u0026ndash;15].\u003c/p\u003e\n\u003cp\u003eThe community demonstrated a willingness to contribute to PCC, both financially and through active participation in clinic management. This finding resonates with the task-shifting approaches described by Deller et al., [16] where community health workers and other local actors played pivotal roles in promoting maternal and newborn health services in resource-limited settings. These findings echo recommendations by Chutke et al. [17]\u0026nbsp;and Nomita Chandhiok et. al., [11] who emphasized using local networks and health workers to deliver PCC in rural areas. However, the varying levels of financial contributions reported in this study suggest the need for flexible and inclusive funding mechanisms to ensure equitable access. This aligns with previous findings that emphasize the need for sustainable models combining community involvement with external support [11,16]. This resonates with findings from Ojifinni et al.,[18] where high costs and logistical issues were major barriers to PCC adoption in low-resource settings. Current study underscores the gaps in awareness and access to PCC services, pointing to the need for better integration of PCC within existing healthcare frameworks, similar findings are shown by Annadurai K. et. al. [19] and Kolhe R et al. [9].\u003c/p\u003e\n\u003cp\u003eThe community expressed a strong need for comprehensive PCC services, including essential health tests (e.g., blood tests, genetic screening), counseling on family planning, and education on healthy pregnancies. There was a particular focus on addressing non-communicable diseases (NCDs) like diabetes and hypertension, which reflects the growing recognition of their impact on maternal health. This aligns with Ebrahim et al., [20] who highlighted the importance of integrating preventive care, such as NCD management, into PCC programs. Additionally, the emphasis on family wellbeing and targeted education for adolescent girls (Kishori) underscores the need for culturally sensitive interventions that prepare young women for healthy motherhood.\u003c/p\u003e\n\u003cp\u003eOur findings align with many of the PCC elements recommended by WHO, but they also reveal additional priorities specific to the local context. For example, while WHO emphasizes preventing disease transmission, the community in this study prioritized Health Screening and Family Wellbeing as critical components of PCC. Health Screening emerged as a key package, addressing conditions like diabetes, hypertension, and thyroid disorders, which are not prominently highlighted in WHO\u0026rsquo;s guidelines. Similarly, the focus on family wellbeing, covering family dynamics, child spacing, and reducing stigma around reproductive health, adds a unique cultural dimension to PCC implementation [21,22]. These locally enriched priorities highlight the importance of adapting global recommendations to meet the specific needs of the community.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOne of the significant challenges identified in this study was the heavy workload on healthcare providers, which limits their ability to deliver PCC effectively. To address this, the study suggests task-shifting strategies, such as involving trained nurses to manage PCC clinics, which align with the findings by Nomita Chandhiok et al. [11] and Deller B. et al [16]. Similar approaches have been successful in countries like Hong Kong and South Korea, where nurses and midwives play a central role in delivering PCC [20,23]. However, for such strategies to succeed, there must be adequate training, supportive policies, and consistent resources to sustain these initiatives over time. According to few studies Michael P. Daly et al. [23], Yatin V. Pimple et al. [24] and Narendra A. et al. [25] challenges such as poor compliance, low awareness, and weak program monitoring must be tackled to integrate PCC into India\u0026apos;s healthcare system, particularly to achieve Sustainable Development Goals by 2030 which aligns with the finding of the current study. The findings of study by Nada Fussi et al. [26] and Rucha D. Phalke et al. [27] highlight a need for structured training programs to enhance awareness and practice among healthcare workers.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis formative research provides valuable insights into the community\u0026apos;s understanding, contributions, and expectations regarding preconception care (PCC). While the community recognizes the benefits of PCC, such as improved maternal and child health, safer deliveries, and inter-conception care, there remain significant gaps in awareness of key aspects like genetic screening, early disease detection, and self-care practices. The community demonstrated strong support for PCC clinics, with a willingness to contribute financially and manage clinics through local figures like ASHA workers, self-help groups, and educated youth. Preferred locations for clinics included Gram Panchayat offices, Anganwadi centers, and primary healthcare facilities, reflecting the community\u0026rsquo;s emphasis on accessibility and convenience. The comparison with WHO-recommended PCC packages reveals additional locally prioritized areas that address specific community needs. Health Screening emerged as a key package, and Family Wellbeing package highlights the importance of family dynamics, social support, and education for young women, reflecting the cultural significance of collective decision-making in reproductive health. Lifestyle Modification and Addiction package, these community-driven priorities enrich the traditional scope of PCC, emphasizing holistic, culturally sensitive strategies for maternal and child health. The current study highlights the community\u0026apos;s readiness to adopt PCC, provided services are affordable, accessible, and aligned with local priorities. By leveraging existing community networks and addressing gaps in awareness and healthcare delivery, PCC can be effectively integrated into existing healthcare frameworks to ensure better maternal and child health outcomes.\u003c/p\u003e"},{"header":"Limitation of the Study","content":"\u003cp\u003eThe study\u0026apos;s reliance on qualitative methods, while rich in detail, limits its generalizability to other regions or populations. Variations in awareness and prioritization among villages suggest heterogeneity that may not fully represent all community perspectives. Economic concerns raised by participants highlight potential challenges in implementing proposed PCC services, particularly regarding affordability and accessibility for underprivileged groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendation of the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDirect quotes enrich the findings, offering a nuanced understanding of community needs. The comparison with WHO-recommended PCC packages highlights locally prioritized areas such as Health Screening, Family Wellbeing, and Lifestyle Modification, reflecting a community-driven approach. The focus on trans-generational health issues and readiness for financial and logistical support demonstrates strong community engagement and cultural adaptability, making the results practical and actionable.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis study (Proposal ID- IIRP-2023-7250) and (File No: EMTR/SG/DEL/03/5 dated 21 Dec 2023) is being by funded the Indian Council of Medical Research (ICMR).\u003c/p\u003e\u003ch2\u003eAuthors\u0026rsquo; contributions\u003c/h2\u003e \u003cp\u003eThe contributions of the authors to this work are as follows: AVR was responsible for conceptualization, designing the work, project administration, visualization, and writing \u0026ndash; review and editing. KM and MG contributed to data curation, formal analysis, and drafting the original manuscript. SM carried out formal analysis, visualization, and drafting of the original manuscript. PV and SSG were involved in funding acquisition, while RJP and SJ managed project administration. BSG contributed to both funding acquisition and project administration. All authors have reviewed and approved the final manuscript. They have agreed to be personally accountable for their individual contributions and to ensure that any questions regarding the accuracy or integrity of any part of the work, including areas outside their direct involvement, are thoroughly investigated, appropriately resolved, and documented in the literature.\u003c/p\u003e\u003ch2\u003eAcknowledgements:\u003c/h2\u003e \u003cp\u003eOur heartfelt gratitude to all the participants who generously shared their valuable time, insights, and experiences, enabling us to delve deeper into the community's perceptions, preparedness, and expectations regarding preconception care. We are especially thankful to the community health workers, ASHAs, ANMs, and local governing bodies for their support and collaboration during the study. Our sincere appreciation goes to the research team for their unwavering dedication and efforts in conducting this formative research. We also extend our gratitude to Mr. Dinesh for his invaluable assistance in creating our research-based comprehensive Preconception Care (PCC) package.\u003c/p\u003e\u003ch2\u003eAvailability of data and materials:\u003c/h2\u003e \u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSay L, Chou D, Gemmill A, Tun\u0026ccedil;alp \u0026Ouml;, Moller AB, Daniels J et al (2014) Global causes of maternal death: A WHO systematic analysis. Lancet Glob Health. ;2(6)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHemsing N, Greaves L, Poole N (2017) Preconception health care interventions: A scoping review. Sexual and Reproductive Healthcare, vol 14. Elsevier B.V., pp 24\u0026ndash;32\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization Headquarters Meeting to Develop a Global Consensus on Preconception Care to Reduce Maternal and Childhood Mortality and Morbidity [Internet]. Geneva; 2012 Feb [cited 2024 Dec 27]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://iris.who.int/handle/10665/78067\u003c/span\u003e\u003cspan address=\"https://iris.who.int/handle/10665/78067\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhekade H, Potdukhe A, Taksande AB, Wanjari MB, Yelne S (2023) Preconception Care: A Strategic Intervention for the Prevention of Neonatal and Birth Disorders. Cureus. ;15(6)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePoix S, Elmusharaf K (2023) Investigating the pathways from preconception care to preventing maternal, perinatal and child mortality: A scoping review and causal loop diagram. Preventive Medicine Reports, vol 34. Elsevier Inc.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNational Rural Health Mission (2013) Guidelines for Community Processes. Ministry of Health and Family Welfare (MOHFW). Government of India. editor. New Delhi, p 84\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMinistry of Health and Family Welfare (MOHFW) Government of India. Handbook for Members of Village Health Sanitation and Nutrition Committee [Internet]. Ms. Sulakhshana Nandi (Member National ASHA Mentoring Group) and Dr. T. Sundararaman (Executive Director NHSRC, editor. New Delhi: National Health Systems Resource Centre (NHSRC); 2015 [cited 2024 Dec 27]. 35 p. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://nhm.gov.in/images/pdf/communitisation/vhsnc/Resources/Handbook_for_Members_of_VHSNC-English.pdf\u003c/span\u003e\u003cspan address=\"https://nhm.gov.in/images/pdf/communitisation/vhsnc/Resources/Handbook_for_Members_of_VHSNC-English.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization Maternal mortality [Internet]. 2024 Apr [cited 2024 Dec 27]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news-room/fact-sheets/detail/maternal-mortality\u003c/span\u003e\u003cspan address=\"https://www.who.int/news-room/fact-sheets/detail/maternal-mortality\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKolhe RS (2023) Optimizing Health Before Pregnancy: Evaluating the Feasibility of Community-Based Preconception Care Package in Rural Central India. Global Implement Res Appl 4:24\u0026ndash;39\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSingh H, Nair M, Kariya P, Bhatt S, Janardhanan D, Lakshmi Shanthi B et al Indian Academy of Pediatrics Consensus Guidelines on Preconception Care. Blooming Buds Child and Adolescent Care Centre. 12\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChandhiok N, Joglekar N, Shrotri A, Choudhury P, Chaudhury N, Singha S (2015) Task-shifting challenges for provision of skilled birth attendance: A qualitative exploration. Int Health 7(3):195\u0026ndash;203\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDoke PP, Gothankar JS, Pore PD, Palkar SH, Chutke AP, Patil AV et al (2021) Meager Perception of Preconception Care Among Women Desiring Pregnancy in Rural Areas: A Qualitative Study Using Focus Group Discussions. Front Public Health. ;9\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDhakal K (2016) Educational Intervention about Awareness of Preconceptional care: on Impact Among Bachelor Students. J Inst Med Nepal (JIOMN) 38(1):76\u0026ndash;80\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnna James J, Sara George L, Fernandes S (2019) Preconception Care: Existing Knowledge in Karnataka, India and Need for an Intervention Article information Original Research. Women Health Open J 5(1):12\u0026ndash;15\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchoenaker D, Gafari O, Taylor E, Hall J, Barker C, Jones B et al (2024) What Does \u0026lsquo;Preconception Health\u0026rsquo; Mean to People? A Public Consultation on Awareness and Use of Language. Health Expect. ;27(4)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDeller B, Tripathi V, Stender S, Otolorin E, Johnson P, Carr C (2015) Task shifting in maternal and newborn health care: Key components from policy to implementation. Int J Gynecol Obstet 130(S2):S25\u0026ndash;31\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChutke APDPGJPPPSPADABKKM and SA. Perceptions of and challenges faced by primary healthcare workers about preconception services in rural India: A qualitative study using focus group discussion. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003c/span\u003e\u003cspan address=\"http://www.mapsofindia.com\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOjifinni OO, Ibisomi L (2019) Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study [Internet]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.researchsquare.com/article/rs-4580/v2\u003c/span\u003e\u003cspan address=\"https://www.researchsquare.com/article/rs-4580/v2\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnnadurai K, Mani G, Danasekaran R (2017) Preconception care: A pragmatic approach for planned pregnancy. Journal of Research in Medical Sciences, vol 22. Isfahan University of Medical Sciences(IUMS)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEbrahim SH, Lo SST, Zhuo J, Han JY, Delvoye P, Zhu L (2006) Models of preconception care implementation in selected countries. Matern Child Health J 10(1):37\u0026ndash;42\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePoels M, Koster MPH, Franx A, van Stel HF (2017) Parental perspectives on the awareness and delivery of preconception care. BMC Pregnancy Childbirth. ;17(1)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLassi ZS, Dean SV, Mallick D, Bhutta ZA (2014) Preconception care: delivery strategies and packages for care [Internet]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.reproductive-health-journal.com/content/11/S3/S7\u003c/span\u003e\u003cspan address=\"http://www.reproductive-health-journal.com/content/11/S3/S7\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDaly MP, White J, Sanders J, Kipping RR (2022) Women\u0026rsquo;s knowledge, attitudes and views of preconception health and intervention delivery methods: a cross-sectional survey. BMC Pregnancy Childbirth. ;22(1)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePimple Y, Ashturkar M (2016) Preconception care: an Indian context. Int J Community Med Public Health. ;3291\u0026ndash;3296\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNarendra AR, Kowlgi A, Patil GH, Kar NS (2023) A. The why, what and how of preconception care: an exploratory descriptive qualitative study in Karnataka, India. Archives Public Health. ;81(1)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFussi N, Mandoura N (2023) Perceptions and Beliefs About Preconceptional Care Among Primary Healthcare Workers in Jeddah City, Saudi Arabia: An Analytical Cross-Sectional Study. Cureus\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePhalke RD, Patil RT, Jain P, Patil PS, Ambekar HG, Phalke VD (2023) Study of pre-conception care (PCC) amongst women in the first trimester coming to the obstetrics and gynaecology (OBGY) outpatient department (OPD) of a hospital in a rural area. J Family Med Prim Care 12(9):1879\u0026ndash;1884\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":" \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eCommunity Perceptions of PCC: Thematic Insights from FGDs \u0026amp; IDIs\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSecond order-Category\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFirst order\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eVerbatim\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eInter-conception care\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eSpacing between children\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF1-P5\u003c/span\u003e says that \u0026ldquo;there should be knowledge of spacing between two kids\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eGender norm\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eGender preference\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-17\u003c/span\u003e says that \u0026ldquo;if boy child is born then expect for girl child and vice versa, but in most of cases boy child is expected\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-6\u003c/span\u003e says that \u0026ldquo;people check girl or by during pregnancy, but people prefer boy child and because of boy child choice number of girl child is reduced\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF4-P5\u003c/span\u003e says that \u0026ldquo;everyone keep first pregnancy if they have two girl child, then they think of boy child and take one more attempt\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePCC benefits\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eearly detection of diseases, good for mother and baby, healthy pregnancy, safe and healthy delivery, transportation money will be saved if PCC clinic is available at village level\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF7-P4\u003c/span\u003e says \u0026ldquo;PCC will help us to know about sickle cell if it is there in mother\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF3-P1\u003c/span\u003e says that \u0026ldquo;checkup and investigations will help to detect any problem which is already existing prior pregnancy\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF3-P1\u003c/span\u003e says that \u0026ldquo;PCC will help to avoid death during ANC and PNC\u0026rdquo;. FF5-P6 \u0026ldquo;period of care to treat trans-generational disease is before conception.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eViews on PCC\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eUsually, people don\u0026rsquo;t think about PCC but should think, care should be taken before conception, healthy food items should be included in the meal, care has to be taken before 1\u0026ndash;2 years or six months before.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-23\u003c/span\u003e gives views on PCC \u0026ldquo;first of all it is necessary to explain it to all women, they will not say no, because whatever you said me earlier about PCC, I found this topic new, I liked this topic, this topic is new every time, I have never heard about this topic\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF3-P4\u003c/span\u003e says that \u0026ldquo;care should be taken before conception otherwise it will harm baby\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF3-P1\u003c/span\u003e says that PCC will help to avoid abortion and it will save money too\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF3-P1\u003c/span\u003e says that \u0026ldquo;prior treatment can be taken and plan can be made for healthy Pregnancy\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF1-P7\u003c/span\u003e says that \u0026ldquo;before pregnancy AIDS test can be done and treatment can be taken\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF8- P1, P2, P3, P4\u003c/span\u003e says that \u0026ldquo;before conception treatment can be done which is good\u0026rdquo;, FF8-P1 says \u0026ldquo;to avoid miscarriage PCC is important\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-14\u003c/span\u003e says that \u0026ldquo;before conception care and treatment is needed, if mother takes medicine, then baby can be safe\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF4-P1\u003c/span\u003e says that\u0026rdquo; after marriage people should know about their health status then only pregnancy should be planned\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBefore pregnancy blood test\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eHIV, couple test, BP, sugar, treatment, genetic test, vaccine should be taken, sickle cell, TB, asthma\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF5-P6\u003c/span\u003e says that \u0026ldquo;to have healthy baby pregnancy should be planned. To have healthy baby and healthy mother PCC vaccine, and PCC tests are essential\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF2-P1\u003c/span\u003e says that \u0026ldquo;before conception if blood test is done then it is good\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeriod of care for trans-generational diseases\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003ebefore conception shall seek required treatment, if necessary, treatment should be taken 1\u0026ndash;2 years before conception\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF4-P5\u003c/span\u003e says \u0026ldquo;the measures for trans-generational diseases can include male test and female test then treatment can be done before conception\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF4-P1\u003c/span\u003e says that \u0026ldquo;previous test can be done before conception if any doubts of having any genetic disorder, we come to know through blood test reports, proper treatment can be taken to prevent from trans-generational disease, if we know about low HB earlier then required treatment can be done and baby can be safe and disease will not transfer to baby and in case trans-generational disease test done before pregnancy will let us know about mother's and father's health status so, after marriage people should know about their health status then only pregnancy should be planned\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF3-P5\u003c/span\u003e says that \u0026ldquo;before planning for pregnancy father shall undergo treatment for genetic disorder\u0026rdquo;\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAcceptance of PCC clinic\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003emost of the villages are showing their desire for PCC clinic in village, but the villages where there are PHC and other health centres are least interested.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF2-P1, P2, P3, P6\u003c/span\u003e says that \u0026ldquo;there is a need of PCC clinic in village\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-16\u003c/span\u003e says that \u0026ldquo;there is biggest need of PCC clinic in this village as this village is 12 kms far away from the district\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-14\u003c/span\u003e says that \u0026ldquo;it is good concept on village level we will get clinic and there is no need of going outside the village\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-1\u003c/span\u003e \u0026ldquo;female can come doubtful about men visit to PCC clinic\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePCC perception on trans-generational diseases\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eDetecting genetic disorder before conception and treating it will save baby from getting infected from disease.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF4-P4\u003c/span\u003e says that \u0026ldquo;discuss with doctor about previous medical history then\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003edoctor will give treatment so that baby will be safe\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-16\u003c/span\u003e says that \u0026ldquo;hereditary diseases can be controlled prior pregnancy by taking vaccine for 1\u0026ndash;3 years\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eRole of Asha towards Kishori\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAsha guide Kishori regarding self-care and HB maintenance.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eKishori are the future would be mothers\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-2\u003c/span\u003e \u0026ldquo;there is a need to well educate adolescent girls towards their health, because in future they are going to get married and bear children so\u0026hellip;\u0026rdquo;\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSelf-care before conception\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003edisease free mother, healthy balanced diet, exercise, proper weight and height, free environment and stress free.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-15\u003c/span\u003e says that \u0026lsquo;it is good to do test before conception but no one does it, but after conception it becomes mandatory then women do all the treatment\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePerception about PCC fees\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eon charging fees may be most of them will avoid to come to clinic, minimal fee is expected.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-\u003c/span\u003e \u0026ldquo;5 Rs will do\u0026rdquo;. IDI-1 \u0026ldquo;10\u0026ndash;20 Rs\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF2-P6\u003c/span\u003e says that \u0026ldquo;30\u0026thinsp;\u0026minus;\u0026thinsp;20 Rs anyone can give\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF3-P3\u003c/span\u003e says that \u0026ldquo;it should be of free of cost\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF7- P1\u003c/span\u003e says that \u0026ldquo;I think 5\u0026ndash;10 Rs\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF4- P1\u003c/span\u003e says that \u0026ldquo;10 Rs\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003cbr/\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eContributions to Preconception Care: A Thematic Review from FGDs \u0026amp; IDIs\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSecond order-category\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFirst order\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eVerbatim\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eManagement responsibility\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAsha, self-help group, retired personnel, bachatgut members, male preference and\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003eGram Sangh female preference in management. Responsibility\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-23\u003c/span\u003e \u0026ldquo;2\u0026ndash;3 women are there, those are Gram Sangh\u0026rsquo;s president and secretary, we can give to such people\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-5\u003c/span\u003e says that \u0026ldquo;any people can help in management\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-4\u003c/span\u003e says that \u0026ldquo;those who are interested can take management responsibility\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-9\u003c/span\u003e says that \u0026ldquo;any educated boy from village can take the responsibility of clinic management\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePromotion\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eWomen, Asha bachatgut females, ladies group discussion, normal meetings, survey, mouth publicity, whats app can be used for promotion, Gram Panchayat dawandi, meetings in Anganwadi and subcentres and Anganwadi Sevika can promote PCC.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF3-P7\u003c/span\u003e \u0026ldquo;women in village can share information regarding PCC clinic\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF4-P5\u003c/span\u003e \u0026ldquo;bachatgut females can help\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-23\u003c/span\u003e \u0026ldquo;In Sangh meeting, we can tell them we want to open PCC clinic, we can ask them what is their opinion they will say we have clinic in our village, we don\u0026rsquo;t feel PCC clinic\u0026rsquo;s need. Then we can ask them whether they undergo PCC treatment in those clinic, then they will say no, then madam you can proceed with your part of explaining them about PCC\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-3\u003c/span\u003e says that \u0026ldquo; regarding PCC clinic, announcement can be done in village through dawandi\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-2\u003c/span\u003e \u0026ldquo;people meet in field while their works they will discuss about PCC clinic\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-7\u003c/span\u003e says that \u0026ldquo;during mata sabha information can be given to women about PCC clinic in our village\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMoney contribution\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e50,100, 200, 300, 500, 1000, people can contribute as per their economic status.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF4-P5\u003c/span\u003e says that \u0026ldquo;in general people can give 100\u0026ndash;200 Rs\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-23\u003c/span\u003e \u0026ldquo;No, I can\u0026rsquo;t tell about others, I can tell about myself I can give 100 Rs/-\u0026rsquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eLocation of the clinic\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eGram Panchayat, Anganwadi, School, temple, or any vacant room available in village.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-23\u003c/span\u003e \u0026ldquo;In Gram Panchayat one day clinic work can\u0026hellip;.similarly for our work they will provide, because we don\u0026rsquo;t have any other place. We don\u0026rsquo;t have office for Gram Sangh meetings, we conduct our meetings here and there, if we would have our office then we would have provide it for one day of your clinic work, that place would be of my right, no one else would have oppose it\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF5- P8\u003c/span\u003e says that \u0026ldquo;If we think of gram panchayat then will have to take permission.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eP6\u003c/span\u003e- says that Gram Panchayat is one of the places where everyone can gather\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF5- P7\u003c/span\u003e says that \u0026ldquo;you explain your concept to sarpanch, they may help for clinic place in village\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-3\u003c/span\u003e says that \u0026ldquo;it can be government hospital\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-11\u003c/span\u003e says that \u0026ldquo;PHC, two rooms are available at PHC\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003cbr/\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eExpectations for PCC Services: Thematic Findings from FGDs \u0026amp; IDIs\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSecond order-category\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFirst order\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eVerbatim\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eFacility expectation: test expectation\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eBlood test, vaccine, weighing machine, sonography, medicine availability, urine test, in emergency cases doctors should be available, treatment on infertility, service expectation, ambulance availability, Bp, sugar, thyroid, asthma, blood test, urine test, fever, HIV, AIDS, TB, Pneumonia, typhoid, cough and cold and sickle cell test, medication and nutrition supplement expectation.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF2-P1 and P5\u003c/span\u003e says that\u0026rdquo; everything is needed like nutrition supplement, protein powder, milk and banana, vaccine which is given prior pregnancy\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-4\u003c/span\u003e says that \u0026ldquo;service should be free and it will be helpful for BPL people those can\u0026rsquo;t afford greens and rich food\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCounselling expectation\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003efamily counselling, couple counselling, counselling on safe and hygiene pregnancy and life style, counselling on addictions, counselling on infertility, counselling on mother care, counselling on safety in pregnancy, counselling on cleanliness, counselling expectation on baby planning and family planning methods, male counselling expectation, paediatric clinic expectation, counselling on inter-space between two kids, counselling on newly weds, counselling on medicines side effects on health during pregnancy\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF1-P5\u003c/span\u003e says that \u0026ldquo;there should be counselling on space between two kids\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF1-P6\u003c/span\u003e says that \u0026ldquo;there should be counselling on family planning methods and how to conceive?\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF1-P6\u003c/span\u003e says that \u0026ldquo;counselling for newly married couple is required\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF1-P1\u003c/span\u003e says that \u0026ldquo;counselling on male female infection care\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF4-P5\u003c/span\u003e says that \u0026ldquo;family counselling especially for in-laws\u0026rdquo;\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCase paper fee\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e5, 10, 20, 100, 200, 500, free of cost, less fee is expected\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF-P4\u003c/span\u003e says that \u0026ldquo;below poverty line should be able to pay 20 Rs\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF-P7\u003c/span\u003e says that \u0026ldquo;there are financially weak people for them 20 Rs is more then if we keep 10 Rs then more people can come\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF- P6\u003c/span\u003e says that \u0026ldquo; according to financial status anyone can give 30 Rs\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eTreatment expectation\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003emale treatment expectation, treatment on oligohydramnios, mental health treatment, advice by senior doctors.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF4-P5\u003c/span\u003e says that \u0026ldquo;there should be treatment after abortion\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eFacility expectation for Kishori\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003ekishori are the would-be mothers so they should be properly educated towards their health care.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-2\u003c/span\u003e \u0026ldquo;there is a need to well educate adolescent girls towards their health, because in future they are going to get married and bear children so\u0026hellip;\u0026rdquo;\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eEducation on health\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eEducation on health care, promotion expectation from nurse.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF1-P1\u003c/span\u003e says that \u0026ldquo;methods of family planning related information and education is needed\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI \u0026minus;\u0026thinsp;12\u003c/span\u003e says that \u0026ldquo;information related health should be given to people through enjoyment and entertainment\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-2\u003c/span\u003e says that \u0026ldquo;yes counselling is important and if necessary, information is provided then many people will come to clinic\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eHuman resource\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003efemale doctor, male doctor, gynaecologist and Nurse\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFF3-P3\u003c/span\u003e says that \u0026ldquo;in emergency cases doctors should be available\u0026rdquo;\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eMF5-P5\u003c/span\u003e says that \u0026ldquo; male and female doctor both are required\u0026rdquo;.\u003c/div\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eIDI-3\u003c/span\u003e says that \u0026ldquo;\u0026hellip;\u0026hellip;. yes, but for first visit doctor is needed later on Nurse can be managed. Once nurse is introduced to villagers it will work\u0026rdquo;.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003cbr/\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eExpectations for PCC: Insights from Free Listing and Ranking Analysis\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003ePHC\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eVillage\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"12\" nameend=\"c14\" namest=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eFacility expectation\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eNC\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eVPDs\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eGC\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eEH\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eInf\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eMH\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eCont\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eIV\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003eAdd\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eHS\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003eFW\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003eLm\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnji\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eBogaon Nandora\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnji\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eKaranji Kaji\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnji\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eNarsula\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnji\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eBorgaon Sawali\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnji\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eChaka\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eKhrangana\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eKarla\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eKhrangana\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eKutki\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eKhrangana\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eNandora\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eKhrangana\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eDhanora\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eKhrangana\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eMandavgad\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eTalegaon\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eSeloo Kate\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eTalegaon\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eNeri (Mirapur)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eTalegaon\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eInzapur\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eTalegaon\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eBhivapur\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eTalegaon\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAastha\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eWaifad\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eNagthana\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eWaifad\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eLonsowali\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eWaifad\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eDorali\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eWaifad\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eDhamangaon\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eWaifad\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eChikni\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e8\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"14\"\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eNC: Nutritional Conditions, VPDs: Vaccine Preventable Disease, GC: Genetic Conditions, EH: Environmental Health, Inf: Infertility/ Subfertility, MH: Mental Health, FW: Family Wellbeing, IV: Interpersonal violence, Add: Addiction, HS: Health Screening, Cont: Family welfare, Lm: Lifestyle Modification\u003c/span\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003cbr/\u003e"}],"fulltextSource":"","fullText":"","funders":[{"identity":"0abc4471-d8f1-462a-8e43-66de9272cee1","identifier":"10.13039/501100001411","name":"Indian Council of Medical Research","awardNumber":"Proposal ID- IIRP-2023-7250; File No: EMTR/SG/DEL/03/5 dated 21 Dec 2023","order_by":0}],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India ","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Task-Shifting Strategy, Sustainable Healthcare Models, Community Engagement, Panchayat Resource Persons, Preconception Health Care, Community-Based Interventions, Participatory Learning and Action","lastPublishedDoi":"10.21203/rs.3.rs-5749029/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5749029/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: The study explores community perceptions, preparedness, and expectations regarding preconception care (PCC). It evaluates the acceptance of nurses delivering PCC services, the efficiency of a community-based PCC package, and community readiness for village-level PCC services, aiming to co-develop a tailored PCC package.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: This formative research employed a qualitative approach, including focus group discussions (FGDs), in-depth interviews (IDIs), and free listing and ranking exercises. Conducted in 96 villages across four Primary Health Centres in rural Maharashtra, the study involved diverse participants, including eligible couples, village representatives, and community health workers. Data were analyzed using thematic content analysis, employing both deductive and inductive methods to identify themes related to perceptions, contributions, and expectations for PCC.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The study revealed gaps in community awareness of PCC, including genetic screening and early detection. Despite this, members emphasized PCC’s benefits, such as improved maternal health and safer deliveries, showing strong support for accessible clinics with local involvement. Unique priorities like health screening, family wellbeing, and lifestyle modifications enriched PCC, reflecting a holistic approach.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The findings highlight the community's readiness to adopt PCC services, provided they are affordable, accessible, and tailored to local needs. The study underscores the importance of culturally sensitive approaches and leveraging community networks to promote PCC. Integrating locally prioritized areas into PCC frameworks can enhance maternal and child health outcomes and ensure effective implementation in resource-limited settings.\u003c/p\u003e","manuscriptTitle":"Understanding Community Perceptions, Preparedness, and Expectations of Preconception Care: A Formative Research Approach","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-06 13:42:39","doi":"10.21203/rs.3.rs-5749029/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5dfd28b9-935b-4755-bba1-772eb51de747","owner":[],"postedDate":"January 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":42252108,"name":"Women's studies"},{"id":42252109,"name":"Sexual \u0026 Reproductive Medicine"},{"id":42252110,"name":"Preventive Medicine"}],"tags":[],"updatedAt":"2025-01-06T13:42:40+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-06 13:42:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5749029","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5749029","identity":"rs-5749029","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}