Utilization of Preconception Care and Its Determinants Among Pregnant Women Attending ANC in Private MCH Hospitals in Addis Ababa, Ethiopia: A Cross Sectional Descriptive Study

Utilization of Preconception Care and Its Determinants Among Pregnant Women Attending ANC in Private MCH Hospitals in Addis Ababa, Ethiopia: A Cross Sectional Descriptive Study | 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 Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Utilization of Preconception Care and Its Determinants Among Pregnant Women Attending ANC in Private MCH Hospitals in Addis Ababa, Ethiopia: A Cross Sectional Descriptive Study Addisu Girma, Abera Bedada, Solomon Kumbi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2842453/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 08 Sep, 2023 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted 8 You are reading this latest preprint version Abstract Background Regardless of its benefit in promoting maternal health and the health of her developing fetus, and little is known about preconception care practice in Ethiopia. The purpose of this study, therefore, is to determine the utilization of preconception health care services and its determinants among women following ANC in Private MCH Hospitals in Addis Ababa. Methods A Hospital based cross-sectional study was conducted from April 1 to April 30,2022 among 385 women attending ANC in Private MCH Hospitals. Data were collected by a pretested self-administered semi-structured questionnaire. To identify the determinants associated with the utilization of preconception care bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratios (AOR) with 95% CI were estimated to assess the strength of associations and statistical significance was declared at a p-value < 0.05. Results The utilization of PCC among the pregnant mothers according to our study was 40%. Professional/technical/managerial occupation (AOR = 4.3, 95%CI = 1.13, 16.33), good knowledge on PCC (AOR = 3.5, 95%CI = 1.92, 6.53),having unintended pregnancy (AOR = 0.1, 95%CI = 0.03, 042), history of family planning use before conception (AOR = 3.9, 95%CI = 1.20, 12.60), having pre-existing medical disease(s) (AOR = 8.4, 95%CI = 2.83, 24.74) and having obstetric problem(s) in previous pregnancies (AOR = 3.2, 95%CI = 1.55, 6.50) were significantly associated with preconception care utilization. Conclusions This study found out that the utilization of preconception care in the private MCH Hospitals is still low i.e., only 40%. Occupation, level of knowledge, having intended pregnancy, history of family planning use before conception, having obstetric problem(s) in previous pregnancy and having pre-existing medical condition(s) were independently associated with preconception care utilization. Lack of awareness about the availability of the services and having unintended pregnancy were the main reasons for not utilizing the PCC services. Preconception care Private MCH Hospitals Addis Ababa Determinants Utilization Figures Figure 1 Figure 2 Background Preconception care(PCC) is defined as a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management( 1 ). Research has found that while interventions during pregnancy and childbirth are essential for improving outcomes, they are inadequate for realizing on going international improvements in perinatal health and achieving equitable outcomes for all people. The shift toward preconception health was put into motion over a decade ago to challenge this paradigm and focus attention, intervention, and support on the person before pregnancy( 2 ). Ethiopia has achieved remarkable success in reducing neonatal and maternal mortality in recent decades, but still has very high neonatal mortality rates (29 deaths per 1,000 live births) and maternal mortality ratios (412 deaths per 100,000 live births)( 3 ). One of the main reasons why maternal mortality is high in sub-Saharan Africa is high rates of child marriage and unintended pregnancies apart from inadequate quality health care in time to address complications( 4 ). Ethiopia has one of the highest rate of teenage pregnancy 23.59%( 5 ) and unintended pregnancy among reproductive age group 28%( 6 ). Therefore, there is little doubt that preconception care would make significant improvement for our country in these regards. Several studies conducted to look at the level of PCC across the world found the levels to be generally low. Utilization of preconception across the world in China, Malaysia, and Sir Lanka is 40.0% ( 7 ), 44% ( 8 ), and 27.2%( 9 ) respectively. Preconception care utilization in African countries like Nigeria and Ethiopia 10.3%( 10 ), and 16.27%( 11 ) respectively, which is much lower than other developed world. Moreover, preconception care utilization in private setup is generally not well studied. One study in Kenya found the preconception care utilization in private hospital were 35.% compared to16.1% rural public hospital( 12 ). Based on different articles finding, utilization of preconception is influenced by age, gender, educational status, ethnicity, income, and marital status, history of family planning use, health condition, history of ANC visit, parity, pregnancy intention and gravidity( 7 – 12 ). In Ethiopia, several studies have been conducted to assess the utilization rate of preconception health care services among reproductive age women, pregnant and delivered women in community settings and public institutions and the utilization rate was found to be low( 11 ). However, similar studies in private institutions are lacking. Hence, this study intends to determine the utilization of preconception health care services in private institutions. Methods Study setting and study period A Hospital based study was conducted in two selected private MCH hospitals in Addis Ababa from April 1–30, 2022. As of 2018, the city has a total estimated population size of 7,823,600. Regarding health facilities and health services, there are 994 clinics, 99 health centers and 42 hospitals. Of the hospitals, 15 are registered public and 27 are registered private hospitals. Of the private hospitals, 8 are maternity specialty hospitals i.e., Maternal and Child Health Hospitals. Study Participants Source population was all women who have been following ANC in Addis Ababa at Betsega and Hemen MCH hospitals. Study participants were women following ANC in during the study period were the study population. Pregnant women who moved to Addis Ababa after conceiving were excluded from the study. Sampling Technique and Procedure Of the Private MCH Hospitals, Betsega and Hemen MCH hospitals were selected by convenience. In selected hospitals, all pregnant women attending antenatal clinic within the study period were recruited and participants were selected consecutively until the desired sample size was achieved to ensure that the entire population of antenatal attendees seen at the facility who consented to participate were involved. Sample Size Determination The sample size was calculated by using a single population proportion formula = Z2p(p-1)/d2 with assumptions of 35.1%, from Kenyan study( 12 ) the population proportion of preconception care utilization in private institution, assuming 95% confidence interval, marginal error of 5% (0.05) and 10% non-response rate. \(n =\frac{{Z}^{2} \text{x} \left(\text{p}\text{q} \right)}{ {d}^{2}}\) p = 35.1%=0.351 q = 1-p, Zα = 1.96 and d = 0.05 = \(\frac{{1.96}^{2} \text{x} 0.35(1-0.35)}{{0.05}^{2}}\) =350 Adding 10% of no respondent participants; 350 + 0. 1x 350 = 385 Study Variables The Dependent Variable in this study was utilization of preconception care services among women following ANC. The Independent Variables were Socio-demographic variables, Previous obstetric problems, Preexisting medical illnesses, The knowledge level on preconception care services, Accessibility to preconception services, Availability of preconception services, Affordability of preconception care services and partner’s support. Operational Definition and Terms Intended pregnancy a pregnancy that occurred if a woman wanted to become pregnant at or just before the time of conception. Unintended pregnancy a pregnancy either mistimed or unwanted at a time of conception Pregnancy outcome Results of conception and ensuing pregnancy for example live birth stillbirth, spontaneous abortion. Cigarette smoking Had a history of smoking or currently smoke regardless of amount. Alcohol consumption Intake of alcoholic drinks of any amount or type other than holidays and culturally special ceremony days. Good knowledge those who have scored above or equal to 50% of the correct responses to preconception care knowledge questions. Poor knowledge those who have scored less than 50% of the correct responses to preconception care knowledge questions. Preconception care Any interventions either advice or treatment, and lifestyle modification women received regarding components of preconception care before being pregnant. Preconception care utilization If women received at least one type of intervention, either advice or treatment, and lifestyle modification care i.e., mentioned above at least once before being pregnant will be considered as mother utilized PCC. Private MCH Hospitals Women’s and children’s specialty hospitals managed by individuals or groups, and which is not funded by the State, a public body or Non-governmental Organization. Data Collection Procedures and Quality Assurance A data from pregnant woman following ANC was collected by a self-administered semi-structured questionnaire developed from previous published literature after modification to fit the research objective. The questionnaire was initially prepared in English and then translated into Amharic (local language) by different language experts of both languages and then to English to check its consistency. The questionnaire was used to elicit information regarding sociodemographic characteristics, knowledge about PCC, utilization of PCC prior to the current pregnancy and factors affecting the utilization of PCC. The data was administered by nurses. The questionnaire was pretested two weeks before the actual data collection with 5% of the sample size (20 pregnant women) in Zewditu Memorial Hospital in Addis Ababa and the necessary amendment was done on the questionnaire per pretest result. The overall activities of data collection were supervised and coordinated by the investigators. The collected data were checked for consistency, completeness, and relevance daily during the entire data collection by the principal investigator. After the data were collected from the respondents, it was translated back to English and analyzed using the statistical package SPSS version 26. Data Processing and Analysis The collected data were entered to Statistical Package for Social Science (SPSS) version 26.0 for analysis. Descriptive statistics were done to describe the data. Binary logistic regression analysis was employed to examine the statistical association between utilization of preconception care and every single independent variable. Variables that showed statistical significance during Bivariable analysis at (p-value < 0. 25) were entered into multivariable logistic regression to identify statistically significant variables. Multicollinearity was tested by using the variance inflation factor and tolerance test. The Hosmer-Lemeshow test was used to check the model fitness for analysis. Adjusted odds ratios (AOR) with 95% CI were estimated to assess the strength of associations and statistical significance was declared at a p-value < 0.05. Tables, figures, and text were used to present results. Results 1. Sociodemographic Characteristics the Study Participants Table 1. The sociodemographic characteristics of study participants among Pregnant Women Attending ANC in Betsega and Hemen MCH Hospitals in Addis Ababa, Ethiopia,2022 (n-385) Variables Category Frequency Percent Study Hospitals Betsega Maternity and Children Hospital 193 50.1 Hemen Maternity and Children Hospital 192 49.9 Age ≤ 24 36 9.4 25–34 261 67.8 ≥ 35 88 22.9 Educational status Primary 26 6.8 Secondary 72 18.7 Tertiary 287 74.5 Religion Orthodox 261 67.8 Muslim 51 13.2 Protestant 59 15.3 Catholic 14 3.6 Marital Status Single 12 3.1 Married 364 94.5 Divorced 9 2.3 Occupation Professional/technical/managerial 152 39.5 Sales and Services 197 51.2 Skilled Manual 5 1.3 Housewife 31 8.1 Monthly income 37.5-60USD 1 13 3.4 60-120USD 43 11.2 120-390USD 234 60.8 > 390USD 95 24.7 1: USD = United States dollar 2. Obstetric and Medical Characteristics of the Study Participants Regarding Obstetrics characteristics, 56% of the participants were multiparous followed by nulliparous (40.5%). With regard to ANC booking, 93.5% of them booked at gestational age less than 16weeks. In this study, 23.6% had history of prior obstetric problem(s) and abortion was the commonest which accounts 45.1% followed by still birth (18.7%). The detail obstetric and medical characteristics of study participants depicted in below (Table 2 ). Table 2 Obstetric and medical characteristics of pregnant women attending ANC at Betsega and Hemen MCH Hospitals, Addis Ababa, Ethiopia, 2022 n = 385) Variables Category Frequency Percent Parity Nulliparous 156 40.5 1–4 214 55.6 Grand multiparous (> 4) 15 3.9 GA 1 at booking of current pregnancy < 1month 64 16.6 1-2month 178 46.2 2-3month 86 22.3 3-4month 32 8.3 5month and above 25 6.5 Obstetric problems in the previous pregnancies Yes 91 23.6 No 294 76.4 Any obstetric problems Abortion 41 45.1 Stillbirth 17 18.7 Early neonatal death 5 5.5 Congenital anomaly 9 9.9 Preterm birth 11 12.1 Others 8 8.8 Preexisting medical conditions Yes 48 12.5 No 337 87.5 Any preexisting medical conditions Hypertension 22 45.8 Diabetes 16 33.3 Cardiac disease 5 10.4 Others (Epilepsy, SLE 2 , Liver disease, Thyroid disease) 5 10.4 1: Gestational age 2: Systemic Lupus Erythematosus 3. Knowledge About Preconception Care The finding of this study showed that 58% (223/385) of the participants had good knowledge on preconception care. Concerning the specific knowledge, 91% had ever heard about preconception care and 57.4% heard from health facility, while 20.8% heard via mass media. Family planning and Screening for medical conditions like diabetes, hypertension are mentioned as components of preconception care by 75.1% and 67.5% of the study participants, respectively. About 52.5% of them also mentioned screening for infectious disease like HIV, Syphilis, Hepatitis B virus as a components of preconception care. Furthermore, 76.4% of the pregnant participants know that a woman should stop using Alcohol and Smoking cigarette before conception and 68.1% of them know that a woman should have a healthy diet and use folic acid before conception (See Table 3 below). Table 3 Participants Response for Knowledge Questions Regarding Preconception Care among Pregnant Women of Betsega and Hemen MCH Hospitals, AA, Ethiopia, 2022 (n = 385). Variables (Knowledge Questions) Response Frequency Percent Ever heard of Preconception care Yes 350 90.9 No 35 9.1 Where did you hear about PCC Health Facility 221 62.6 In community 45 12.7 Mass media 80 22.7 Internet 7 2 Family planning is a component of PCC Yes 289 75.1 No 96 24.9 Immunization is a component of PCC Yes 210 54.5 No 175 45.5 Screening for medical conditions; diabetes, hypertension, asthma, epilepsy. Yes 260 67.5 No 125 32.5 Stopping use of environmental toxins; Alcohol and Smoking Yes 220 57.1 No 165 42.9 Lifestyle changes; Healthy weight, Healthy diet, and Folic acid supplementation Yes 214 55.6 No 171 44.4 Screening for Infectious disease; HIV, Syphilis, Hepatitis B virus Yes 202 52.5 No 183 47.5 A woman should be on family planning during preconception period Yes 253 65.7 No 132 34.3 A woman should be vaccinated before she conceives Yes 137 35.6 No 248 64.4 A woman should be screened for medical conditions like Hypertension and Diabetes Yes 304 79.0 No 81 21.0 A woman should stop using Alcohol and Smoking cigarette before conception Yes 294 76.4 No 91 23.6 A woman should a healthy weight and use folic acid before conception Yes 262 68.1 No 123 31.9 A woman should be screened for familial diseases Yes 242 62.9 No 143 37.1 A woman should be screened for infectious diseases like HIV, HBV, Syphilis and Gonorrhea Yes 271 70.4 No 114 29.6 4. Utilization of Preconception Care Services The finding of this study showed that 40% of the study participants received preconception care before the current pregnancy (see Fig. 1 ). No significant differences were noted in the sociodemographic characteristics between the two MCH hospitals except for religion, the level of income, gestational age at booking and previous obstetric problems. Unsurprisingly, the utilization of preconception care is almost similar between the hospitals i.e.,37.3% and 42.7% for Betsega and Hemen MCH Hospital, respectively. In 59.5% (229/385) of the study participants, their current pregnancy was intended and 56.9% (219/385) of the participants were using family planning before conception. The most frequently used types of preconception care services in this study were screening and management of chronic medical conditions 94.8% (146/154) and the most common screened medical condition was hypertension 88.9% (137/154), and the least utilized preconception service was immunization 33.1.4% (51/154) (see Fig. 2 ). Other interesting findings in this study were 20.3% (78/385) of the pregnant were drinking alcohol before conception, of which forty-five of them still drinking alcohol until the end of the first trimester. Similarly, 1.8% (7/385) of the pregnant women were using cigarette smoking before conception and five of them were still smoking cigarette until the end first trimester. On the contrary, only 30.6% the pregnant women were advised on cessation of alcohol and smoking cigarette during preconception period (see Table 4 ). Table 4 Utilization of preconception care services among pregnant women in Betsega and Hemen MCH Hospitals, AA, Ethiopia,2022 (n = 385) Variable Response Frequency Percent Pregnancy intention Yes 229 59.5 No 156 40.5 Family planning use before conception Yes 219 56.9 No 166 43.1 Immunization before conception Yes 51 13.2 No 334 86.8 Screened for any medical conditions before conception Yes 146 37.9 No 239 62.1 Medical conditions screened for before conception Hypertension 137 35.6 Diabetes 124 32.2 HIV 136 35.2 Syphilis 94 24.4 Anemia 112 29.1 Advised on the effects of alcohol and cigarette smoking on pregnancy before conception Yes 118 30.6 No 267 69.4 Were you using Alcohol before conception Yes 78 20.3 No 307 79.7 When did you stop using Alcohol 2month before conception 27 34.6 2 months after conception 45 57.7 Never 6 7.7 Were you using Cigarette before conception Yes 7 1.8 No 378 98.2 When did you to stop using Cigarette smoking 2month before conception 2 28.6 2 months after conception 5 71.4 Never How many months before conception did you start using folic acid a month before conception 48 12.5 2-3month before conception 72 18.7 3month after conception 100 26.0 Never 165 42.9 Advised to have a healthy weight before conception Yes 85 22.1 No 300 77.9 5. Partner support and Heath facility In this study 362/385 (94%) of mothers make a decision about maternal health services with their partner (Table 5 ). The most common supports provided by their partner were accompanying to the health facility 69.9% followed by psychological support 67% and the most common reasons cited by the mothers as problems when they want to start preconception care were long distance from health facility 25.7% and availability of health care provider 15.1%. In addition, 75.3% of the pregnant women cited the cost of preconception care services as fair. The most common reasons for not receiving PCC among the pregnant women who had not received it were lack of awareness of the availability of the services 64.8% followed by because their pregnancy wasn’t expected 28.1% and only 11.7% not accepted the importance of preconception care (see Table 5 ). Table 5 Health Facility and Parental Support among Pregnant Women in Betsega and Hemen MCH Hospitals(n = 385) Variables Category Frequency Percent Decision maker regarding utilization of reproductive health services Women 21 5.5 Partner 2 0.5 Joint 362 94 The type of support your partner offered during preconception Accompanying to the health facility 269 69.9 Financial support 234 60.8 Psychological support 258 67 Spiritual support 204 53 Were the following problems when you want to receive preconception care services? Long distance from health facility 99 25.7 Availability of health care providers 58 15.1 Perception of being low risk 57 14.8 Transport money 38 9.9 Religion 7 1.8 How affordable is the cost? Expensive 69 17.9 Fair 290 75.3 Cheap 26 6.7 If you did not receive any form of PCC services, what do you think is the reason? Not aware that the service is available in the country 136 58.9 The pregnancy was not expected 65 28.1 It is not important before conception 27 11.7 Others 3 1.3 6. Determinants of Preconception Care Utilization The strength of association between independent variables and outcome variable (preconception care utilization) were measured using odds ratio and 95% confidence interval using binary logistics regression model. Accordingly, maternal age, educational status, marital status, occupation, monthly income, knowledge on preconception care, parity, family planning use, intended pregnancy, obstetric problem in previous pregnancy and preexisting medical condition had a p-value of ≤ 0.25 in the bivariable analysis and taken into the final model for multivariable analysis. In multivariable logistic regression analysis, occupation, knowledge on preconception care, family planning use, intended pregnancy, obstetric problem in previous pregnancy and preexisting medical condition were significantly associated with utilization of PCC at p-value of ≤ 0.05(see Table 6 ). Pregnant woman whose occupation is professional/technical/managerial were 4.3 times more likely to receive preconception care when compared to the housewives (AOR = 4.3, 95%CI = 1.13, 16.33). P < 0.032). Those pregnant women who had good knowledge on PCC were 3.5 times more likely to utilize PCC than those having poor knowledge (AOR = 3.5, 95%CI = 1.92, 6.53, P < 0.000). Pregnant mothers who had an unintended pregnancy were 90% less likely to utilize PCC compared to whose pregnancy were intended and those using family planning before conception were 3.9 times more likely to seek preconception care than mothers who weren’t using family planning before conception (AOR = 0.10, 95%CI = 0.03,0.42, P < 0.001).and (AOR = 3.9, 95%CI = 1.20, 12.60, P < 0.023). Lastly, those having pre-existing medical disease(s) and obstetric problem(s) in previous pregnancy were 8.4 and 3.2 times more likely to utilize PCC than who had not (AOR = 8.4, 95%CI = 2.83, 24.74, P < 0.000) and (AOR = 3.2, 95%CI = 1.55, 6.50, P < 0.002). Table 6 Bivariable and Multivariable Logistic Regression Analysis of Factors determining Utilization of PCC among Pregnant Women having ANC in private setting, AA, 2022 (n = 385) Variable PCC P-value COR (95%CI) P-value AOR (95%CI) Yes No Age ≤ 24 11 25 1 1 25–34 100 161 0.369 1.4(0.67, 2.99) 0.690 0.8(0.26, 2.44) ≥ 35 43 45 0.065 2.2(0.95, 4.94) 0.656 0.7(0.23, 2.54) Education status Primary 6 20 1 1 Secondary 22 50 0.471 1.5(0.52, 4.15) 0.946 1.0(0.22, 4.99) Tertiary 126 161 0.046 2.6(1.02, 6.69) 0.829 1.2(0.28, 4.91) Marital Status Single 2 9 1 1 Married 148 217 0.155 3.0(0.65,14.40) 0.115 1.9(0.25,14.05) Divorced 4 5 0.214 3.6(0.48, 27.11) 0.176 1.5(0.07,31.41) Occupation Professional/Technical/ Managerial 77 75 0.003 4.3(1.66, 11.02) 0.032 4.3(1.13, 16.33) Sales and Services 70 127 0.082 2.3(0.90, 5.86) 0.084 3.2(0.85, 12.03) Skilled Manual 1 4 0.973 1.0(0.10, 11.01) 0.874 1.8(0.001,2592) Housewives 6 25 1 1 Monthly Income 1955-3130ETB 3 10 0.111 0.33(0.08,1.29) 0.127 0.2(0.03, 1.54) 3130- 6260ETB 13 30 0.061 0.48(0.22,1.03) 0.692 1.2(0.40, 3.93) 6260-20,335ETB 93 141 0.205 0.73(0.45,1.18) 0.805 1.1(0.55, 2.17) > 20,335ETB) 45 50 1 Level of knowledge Good knowledge 124 99 0.000 5.5(3.42, 8.87) 0.000 3.5(1.92, 6.53) Poor Knowledge 30 132 1 1 Parity Nulliparous 68 87 1 1 2–4 79 135 0.178 0.7(0.5, 1.14) 0.515 0.8(0.45, 1.50) ≥ 5 7 9 0.993 1.0(0.35, 2.8) 0.168 3.0(0.63,14.12) Pregnancy Intention Yes 142 87 1 0.05(0.03, 0.10) 1 0.1(0.03, 0.42) No 12 144 0.000 0.001 Family planning use before conception Yes 140 79 0.000 19(10.4, 35.5) 0.023 3.9(1.20,12.60) No 14 152 1 1 Obstetric problems in the previous pregnancies Yes 60 31 0.000 4.1(2.50, 6.77) 0.002 3.2(1.55, 6.50) No 94 200 1 1 Have any preexisting medical conditions Yes 36 12 0.000 5.5(2.8, 11.10) 0.000 8.4(2.83, 24.74) No 118 219 1 1 Discussion Preconception care (PCC) an approach to optimize pregnancy outcomes which is crucial for many Sub-Saharan African countries, such as Ethiopia, where maternal and perinatal mortality remains alarmingly high. This study found that the prevalence of preconception care utilization among the study participants was considerably low, i.e., 40%. This is similar with findings from China(40%)( 7 ), Malaysia (44%)( 8 )and Kenya(35.1%)( 12 ). The study finding showed higher uptake of preconception care compared to studies done in Nigeria by Ekem et.al 10.3% and Adeyemo et.al 18.8%( 10 , 13 ), Siri Lanka by Patabendige M. et.al 27.2% ( 9 )and community-based studies in Ethiopia (Debre Birhan Town 13.4%,Mekelle City 18.2%, West Guji 22.3%)( 14 – 16 ). The reason for the difference could be due to the different study setting and difference in the sociodemographic characteristics of the study participants. The most common types of preconception services utilized by the mothers were screening and management of chronic medical conditions (94.8%) and the least utilized preconception service was Immunization 33.1%. This finding different from a study done Mekelle city in which the most common utilized component of PCC was micronutrient supplementation (i.e., iron, folic acid) ( 15 ). In addition, this study found that pregnant woman whose occupation is professional/technical/managerial were 4.3 times more likely to receive preconception care when compared to the housewives (AOR = 4.3, 95%CI = 1.13, 16.33, P < 0.032). This is consistent with the study done in France( 17 ) and Nigeria( 13 ). This might be because of individuals working at professional/technical/managerial position are more likely to have better knowledge regarding preconception care and might have also better access to information than the housewives. Awareness and knowledge were significantly associated with utilization of preconception care in several studies( 13 , 15 , 16 , 18 ). In this study 90.9% (350/385) of the respondents ever heard of preconception care. The main source of information was healthcare providers in 62.6% (221/350), mass media in 22.7% (80/350), community in 12.7% (45/350) and internet 2% (7/350). Similarly, 58% (223/385) of the participants had good knowledge on preconception care. This finding is different from studies done in Ethiopia( 16 , 19 ) and Nigeria( 18 ) which showed lower awareness and knowledge about preconception care among pregnant women which might be due the different study settings and different sociodemographic background of the study population. In this study pregnant women who had good knowledge about PCC were 3.5 times more likely to utilize PCC when compared to their counterparts who had poor knowledge about preconception care (AOR = 3.5, 95%CI = 1.92, 6.53, P < 0.000). This finding is consistent with studies done in Hosanna Town, which showed 82% reduced odds of utilizing preconception care among women who had poor knowledge on preconception care than their counterparts (AOR = 0.18; 95% Cl (0.084, 0.379)( 20 ) and West Guji which also showed 2.43 times odds of utilizing PCC among women having good knowledge good compared to their counterparts (AOR = 2.34 95% CI, 1.05, 5.28)( 16 ). Study in Malaysia( 8 ),also showed positive association between good knowledge about preconception care and PCC utilization. This might be because good knowledge about preconception care help them know details about the importance of service. In addition to that, knowledge about PCC might improve attitudes towards PCC that might in turn improve the utilization of preconception care. Similarly, pregnant mothers who had an unintended pregnancy were 90% less likely to utilize PCC compared to whose pregnancy were intended and those using family planning before conception were 3.9 times more likely to seek preconception care than mothers who weren’t using family planning before conception (AOR = 0.10, 95%CI = 0.03,0.42, P < 0.001).and (AOR = 3.9, 95%CI = 1.20, 12.60, P < 0.023). This finding is consistent with studies done in Hosanna Town( 20 ) which showed that the odds of utilizing preconception care in women who had used family planning before current pregnancy were 2.45 times higher than those women who had not used family planning before current pregnancy (AOR = 2.45; 95% Cl (1.270, 4.741). Another study in Los Angeles( 21 ) also showed among women with adverse pregnancy outcomes, having unintended pregnancy was associated with 70% lower odds of not utilizing preconception care(AOR = 0.332;95%CI (0.283, 0.391). This is because those pregnant mothers who planned their pregnancy are more likely to visit health facility to seek family planning services hence might have broader opportunities to receive preconception counselling services. Furthermore, pregnant women having preexisting medical disease(s) and obstetric problem(s) in previous pregnancy were 8.4 and 3.2 times more likely to utilize PCC than who had not (AOR = 8.4, 95%CI = 2.83, 24.74, P < 0.000) and (AOR = 3.2, 95%CI = 1.55, 6.50, P < 0.002). These findings are consistent with studies done in Malaysia( 8 ),Los Angeles ( 21 ) and Mekelle City( 15 ). It can be assumed that these patients are more likely to have frequent health facility visits hence more likely to have adequate information regarding the effect of their medical diseases on pregnancy. In the same line, those pregnant mothers with previous obstetric problem(s) are more likely to be concerned and might have heightened risk awareness compared to who had not. Moreover, about 75% of the study participants found no problem in accessing health facilities. This is similar to studies done in Hosanna Town and West Guji majority of women found no problem in accessing health facilities( 16 , 20 ). In addition, 75.3% of the pregnant women cited the cost of preconception care services as fair. Lastly, among the pregnant mothers who did not receive PCC services when asked their reason for not receiving the care, two-thirds stated they were not aware that the service is available, one-third stated their pregnancy was not expected and about 11.7% think it is not important to them. This finding is similar to studies done in Los Angeles ( 21 ) which found that the common reason cited for not receiving PCC were not having pregnancy intended. This shows that even though the awareness and knowledge is good and only few of them had poor attitude toward preconception care, only less than half utilized PCC services. The plausible explanation for the low uptake in this study could be lack of awareness regarding the availability of the services and having unintended pregnancy. Strength of the study It is one of the very few studies conducted in Ethiopia in the area of PCC in private setting. It has given some information about the prevalence of alcohol intake and smoking cigarette during pregnancy in Ethiopia. Limitation of the study Recall bias is a limitation of the study due to the nature of problem under the study requiring the potential ability of respondents to remember information retrospectively. Selection bias is also a limitation as the study hospitals were chosen by the convenience sampling method. The impact of husband’s educational attainment on PCC utilization was not included. Certain components of preconception care were not studied. Conclusions This study found that the utilization of preconception care in the private institution is still low i.e., only 40%. Occupation, level of knowledge, having intended pregnancy, history of family planning use before conception, having obstetric problem(s) in previous pregnancy and having pre-existing medical condition(s) were independently associated with preconception care utilization. Lack of awareness regarding the availability of the PCC services and having unintended pregnancy were the obstacles for not receiving PCC. Recommendations Health education regarding the importance and the availability of PCC services should be given to women of reproductive age. Interventions aimed at increasing the proportion of intended pregnancies will also be critical to promote the utilization of preconception care services. List Of Abbreviations AA Addis Ababa AKUH Aga Khan University Hospital ANC Antenatal Care AOR Adjusted Odds Ratio BMCH Betsega Maternity and Children Hospital CI Confidence Interval HBV Hepatitis B Virus HIV Human Immunodeficiency Virus HMCH Hemen Maternity and Children Hospital GA Gestational Age IOM Institute of Medicine MCH Maternal and Child Health MLFH Maragua Level Four Hospital OR Odds Ratio PCC Preconception Care PI Principal Investigator SLE Systemic Lupus Erythematosus SPSS Statistical Package for Health sciences WHO World Health Organization Declarations Ethics approval and consent to participate This study was approved by ethical review board of Department of Obstetrics and Gynecology, Addis Ababa University in accordance with Declaration of Helsinki and official letter of permission was obtained from each private Hospital’s administration before data collection. Before participating in the study, the purpose of the study was explained to the study participants and written informed consent was obtained. The collected information was kept confidential through coding. All methods were carried out in accordance with relevant international and local ethical guidelines for research. Availability of data and material The dataset generated during/or analyzed during the current study are not publicly available due to the papers written using this dataset have not been published but are available from corresponding authors on reasonable request. Consent for publications Not applicable Competing interests We the authors declare that we didn’t have any competing interests in this study. Funding The authors have no support or funding to report. Authors’ contributions Conceptualization of the study was done A.G with help of A.B and S.K. A.B and S.K played supervision role during the study processes. A.G carried out the investigation and formal analysis of the data with help of A.B. A.G prepared the original draft of manuscript. All the authors contributed in reviewing and editing of the manuscript. All authors have read and agreed on the final manuscript. Acknowledgements We would like acknowledge Addis Ababa University College of health science for allowing us to conduct this study. We would also like to thank the participants and hospital administrators for their cooperation. References Center for Desease Control and Prevention. Morbidity and Mortality Weekly Report Recommendations and Reports Recommendations to Improve Preconception Health and Health Care-United States A Report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care Centers for. 2006;55. Shawe J, Steegers EAP. Preconception Health and Care: A Life Course Approach. Preconception Health and Care: A Life Course Approach. 2020. USAID. Ethiopia Fact sheet Maternal and Child Health. Nurs Midwifery Board Aust. 2019;035(September):1–3. Why Maternal Mortality Is So High in Sub-Saharan Africa [Internet]. [cited 2023 Apr 7]. Available from: https://www.globalcitizen.org/en/content/maternal-mortality-sub-saharan-africa-causes/ Mamo K, Siyoum M, Birhanu A. Teenage pregnancy and associated factors in Ethiopia: a systematic review and meta-analysis. Int J Adolesc Youth [Internet]. 2021;26(1):501–12. Available from: https://doi.org/10.1080/02673843.2021.2010577 Alene M, Yismaw L, Berelie Y, Kassie B, Yeshambel R, Assemie MA. Prevalence and determinants of unintended pregnancy in Ethiopia: A systematic review and meta-analysis of observational studies. PLoS One [Internet]. 2020;15(4):1–15. Available from: http://dx.doi.org/10.1371/journal.pone.0231012 Ding Y, Li X, Xie F, Yang Y. Survey on the Implementation of Preconception Care in. 2015;492–500. Abu Talib R, Idris IB, Sutan R, Ahmad N, Abu Bakar N. Patterns of pre-pregnancy care usage among reproductive age women in kedah, malaysia. Iran J Public Health. 2018;47(11):1694–702. Patabendige M, Goonewardene IMR. Preconception care received by women attending antenatal clinics at a Teaching Hospital in Southern Sri Lanka. 2013;(March):3–9. Ekem NN, Lawani LO, Onoh RC, Iyoke CA, Ajah LO, Onwe EO, et al. Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria. J Obstet Gynaecol (Lahore) [Internet]. 2018;38(6):739–44. Available from: https://doi.org/10.1080/01443615.2017.1405922 Ayele AD, Belay HG, Kassa BG, Worke MD. Knowledge and utilisation of preconception care and associated factors among women in Ethiopia: systematic review and meta-analysis. Reprod Health [Internet]. 2021;18(1):1–15. Available from: https://doi.org/10.1186/s12978-021-01132-9 Okemo J, Temmerman M, Mwaniki M, Kamya D. Preconception care among pregnant women in an urban and a rural health facility in Kenya: A quantitative study. Int J Environ Res Public Health. 2020;17(20):1–11. Adeyemo AA, Bello OO. Preconception care : What women know , think and do. 2021;20(February):18–26. Demisse TL, Aliyu SA, Kitila SB, Tafesse TT, Gelaw KA, Zerihun MS. Beebe K, Lee K, Carrieri-Kohlman V, Humphreys J. The effects of childbirth self-efficacy and anxiety during pregnancy on prehospitalization labor.J Obstet Gynecol Neonatal Nurs. 2007;36(5):410–8. 2019;1–10. Asresu TT, Hailu D, Girmay B, Abrha MW, Weldearegay HG. Mothers’ utilization and associated factors in preconception care in northern Ethiopia: A community based cross sectional study. BMC Pregnancy Childbirth. 2019;19(1):1–7. Amaje E, Fikrie A, Utura T. Utilization of Preconception Care and Its Associated Factors among Pregnant Women of West Guji Zone, Oromia, Ethiopia, 2021: A Community-Based Cross-Sectional Study. Heal Serv Res Manag Epidemiol. 2022;9:1–10. Paradis S, Ego A, Bosson JL. Preconception care among low-risk mothers in a French perinatal network: Frequency of utilization and factors associated. J Gynecol Obstet Hum Reprod [Internet]. 2017;46(7):591–6. Available from: http://dx.doi.org/10.1016/j.jogoh.2017.05.002 Ezegwui HU, Dim C, Dim N, Ikeme AC. Preconception care in South Eastern Nigeria. J Obstet Gynaecol (Lahore). 2008;28(8):765–8. Ayalew Y, Mulat A, Dile M, Simegn A. Women’s knowledge and associated factors in preconception care in adet, west gojjam, northwest Ethiopia: A community based cross sectional study. Reprod Health [Internet]. 2017;14(1):1–10. Available from: http://dx.doi.org/10.1186/s12978-017-0279-4 Wegene MA, Gejo NG, Bedecha DY, Kerbo AA, Hagisso SN, Damtew SA. Utilization of preconception care and associated factors in Hosanna Town, Southern Ethiopia. PLoS One [Internet]. 2022;17(1 January):1–16. Available from: http://dx.doi.org/10.1371/journal.pone.0261895 Batra P, Higgins C, Chao SM. Previous Adverse Infant Outcomes as Predictors of Preconception Care Use : An Analysis of the 2010 and 2012 Los Angeles Mommy and Baby ( LAMB ) Surveys. Matern Child Health J. 2016;20(6):1177–84. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 08 Sep, 2023 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted Editorial decision: Major revision 24 Jun, 2023 Reviews received at journal 05 Jun, 2023 Reviewers agreed at journal 05 Jun, 2023 Reviewers invited by journal 04 Jun, 2023 Editor assigned by journal 09 May, 2023 Editor invited by journal 09 May, 2023 Submission checks completed at journal 09 May, 2023 First submitted to journal 20 Apr, 2023 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 In Review Editorial Policies 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-2842453","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":198516628,"identity":"0f116687-1a7b-4e33-8309-9e23fbb26472","order_by":0,"name":"Addisu Girma","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYFCCBIMDQJIHiBkfMDAcIFLLAYgWZgOitcDUsUkQpYW/PXnj4Y9ttTLm0w4/q+apuSPHz8D88NENPFokzjwrOHCw7TiPzO00s9s8x54ZSzawGRvn4LPmRo4BUMsxHgnpBKAWtsOJGw7wsEnj0yKP0JL+rZjnHxFaDCBaaoBacsyYeduI0GII8suZcwdAWool5/YdNpZsJuAXuePJmz9UlNXZAx228cObb4fl+NmbHz7G630IOAwmmUARysBMWDkI1IFJxh/EqR4Fo2AUjIIRBgBEj1Q4KZTM3wAAAABJRU5ErkJggg==","orcid":"","institution":"Addis Ababa University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Addisu","middleName":"","lastName":"Girma","suffix":""},{"id":198516629,"identity":"ecb64d0c-5479-4105-81b3-0cbf481c81df","order_by":1,"name":"Abera Bedada","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Abera","middleName":"","lastName":"Bedada","suffix":""},{"id":198516630,"identity":"480cc78b-b392-4efa-ad2d-4e679be21051","order_by":2,"name":"Solomon Kumbi","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Solomon","middleName":"","lastName":"Kumbi","suffix":""}],"badges":[],"createdAt":"2023-04-20 17:59:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2842453/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2842453/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12884-023-05955-1","type":"published","date":"2023-09-08T15:09:47+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":36925972,"identity":"56f07edc-c8cb-4ead-ae38-d284873c33ce","added_by":"auto","created_at":"2023-05-12 03:12:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":232822,"visible":true,"origin":"","legend":"\u003cp\u003eUtilization of preconception care services in Betsega and Hemen MCH Hospitals, AA, Ethiopia, 2022(n=385)\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-2842453/v1/be931339da4be1c3098af047.png"},{"id":36929308,"identity":"e6ab4076-7a56-43e3-872a-ac4e5429f3a9","added_by":"auto","created_at":"2023-05-12 03:25:17","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":182017,"visible":true,"origin":"","legend":"\u003cp\u003eTypes of preconception care services utilized by pregnant women of Betsega and Hemen MCH Hospitals, AA, Ethiopia, 2022(n=385).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-2842453/v1/0034554fa54df432d19b3daa.png"},{"id":42947965,"identity":"8f81ee79-3bc2-48b2-a156-94421a3cd074","added_by":"auto","created_at":"2023-09-11 15:11:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1037116,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2842453/v1/3eab7aa1-9230-40e2-984b-0891b426d76a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Utilization of Preconception Care and Its Determinants Among Pregnant Women Attending ANC in Private MCH Hospitals in Addis Ababa, Ethiopia: A Cross Sectional Descriptive Study","fulltext":[{"header":"Background","content":"\u003cp\u003ePreconception care(PCC) is defined as a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman\u0026rsquo;s health or pregnancy outcome through prevention and management(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Research has found that while interventions during pregnancy and childbirth are essential for improving outcomes, they are inadequate for realizing on going international improvements in perinatal health and achieving equitable outcomes for all people. The shift toward preconception health was put into motion over a decade ago to challenge this paradigm and focus attention, intervention, and support on the person before pregnancy(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEthiopia has achieved remarkable success in reducing neonatal and maternal mortality in recent decades, but still has very high neonatal mortality rates (29 deaths per 1,000 live births) and maternal mortality ratios (412 deaths per 100,000 live births)(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). One of the main reasons why maternal mortality is high in sub-Saharan Africa is high rates of child marriage and unintended pregnancies apart from inadequate quality health care in time to address complications(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Ethiopia has one of the highest rate of teenage pregnancy 23.59%(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) and unintended pregnancy among reproductive age group 28%(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Therefore, there is little doubt that preconception care would make significant improvement for our country in these regards.\u003c/p\u003e \u003cp\u003eSeveral studies conducted to look at the level of PCC across the world found the levels to be generally low. Utilization of preconception across the world in China, Malaysia, and Sir Lanka is 40.0% (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), 44% (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), and 27.2%(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) respectively. Preconception care utilization in African countries like Nigeria and Ethiopia 10.3%(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), and 16.27%(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) respectively, which is much lower than other developed world. Moreover, preconception care utilization in private setup is generally not well studied. One study in Kenya found the preconception care utilization in private hospital were 35.% compared to16.1% rural public hospital(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBased on different articles finding, utilization of preconception is influenced by age, gender, educational status, ethnicity, income, and marital status, history of family planning use, health condition, history of ANC visit, parity, pregnancy intention and gravidity(\u003cspan additionalcitationids=\"CR8 CR9 CR10 CR11\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn Ethiopia, several studies have been conducted to assess the utilization rate of preconception health care services among reproductive age women, pregnant and delivered women in community settings and public institutions and the utilization rate was found to be low(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). However, similar studies in private institutions are lacking. Hence, this study intends to determine the utilization of preconception health care services in private institutions.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy setting and study period\u003c/h2\u003e\n \u003cp\u003eA Hospital based study was conducted in two selected private MCH hospitals in Addis Ababa from April 1\u0026ndash;30, 2022. As of 2018, the city has a total estimated population size of 7,823,600. Regarding health facilities and health services, there are 994 clinics, 99 health centers and 42 hospitals. Of the hospitals, 15 are registered public and 27 are registered private hospitals. Of the private hospitals, 8 are maternity specialty hospitals i.e., Maternal and Child Health Hospitals.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eStudy Participants\u003c/h3\u003e\n\u003cp\u003e\u003cstrong\u003eSource population\u003c/strong\u003e was all women who have been following ANC in Addis Ababa at Betsega and Hemen MCH hospitals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy participants\u003c/strong\u003e were women following ANC in during the study period were the study population. Pregnant women who moved to Addis Ababa after conceiving were excluded from the study.\u003c/p\u003e\n\u003ch3\u003eSampling Technique and Procedure\u003c/h3\u003e\n\u003cp\u003eOf the Private MCH Hospitals, Betsega and Hemen MCH hospitals were selected by convenience. In selected hospitals, all pregnant women attending antenatal clinic within the study period were recruited and participants were selected consecutively until the desired sample size was achieved to ensure that the entire population of antenatal attendees seen at the facility who consented to participate were involved.\u003c/p\u003e\n\u003ch3\u003eSample Size Determination\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated by using a single population proportion formula\u0026thinsp;=\u0026thinsp;Z2p(p-1)/d2 with assumptions of 35.1%, from Kenyan study(\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e) the population proportion of preconception care utilization in private institution, assuming 95% confidence interval, marginal error of 5% (0.05) and 10% non-response rate.\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u0026nbsp;\u003cspan class=\"mathinline\"\u003e\\(n =\\frac{{Z}^{2} \\text{x} \\left(\\text{p}\\text{q} \\right)}{ {d}^{2}}\\)\u003c/span\u003e\u0026nbsp;\u003c/span\u003e p\u0026thinsp;=\u0026thinsp;35.1%=0.351 q\u0026thinsp;=\u0026thinsp;1-p, Z\u0026alpha;\u0026thinsp;=\u0026thinsp;1.96 and d\u0026thinsp;=\u0026thinsp;0.05\u003c/p\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003cp\u003e=\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\frac{{1.96}^{2} \\text{x} 0.35(1-0.35)}{{0.05}^{2}}\\)\u003c/span\u003e\u003c/span\u003e =350\u003c/p\u003e\n \u003cp\u003eAdding 10% of no respondent participants; 350\u0026thinsp;+\u0026thinsp;0. 1x 350\u0026thinsp;=\u0026thinsp;385\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eStudy Variables\u003c/h3\u003e\n\u003cp\u003eThe Dependent Variable in this study was utilization of preconception care services among women following ANC. The Independent Variables were Socio-demographic variables, Previous obstetric problems, Preexisting medical illnesses, The knowledge level on preconception care services, Accessibility to preconception services, Availability of preconception services, Affordability of preconception care services and partner\u0026rsquo;s support.\u003c/p\u003e\n\u003ch3\u003eOperational Definition and Terms\u003c/h3\u003e\n\u003cp\u003e\u003cstrong\u003eIntended pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ea pregnancy that occurred if a woman wanted to become pregnant at or just before the time of conception.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUnintended pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ea pregnancy either mistimed or unwanted at a time of conception\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePregnancy outcome\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResults of conception and ensuing pregnancy for example live birth stillbirth, spontaneous abortion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCigarette smoking\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHad a history of smoking or currently smoke regardless of amount.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAlcohol consumption\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIntake of alcoholic drinks of any amount or type other than holidays and culturally special ceremony days.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGood knowledge\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ethose who have scored above or equal to 50% of the correct responses to preconception care knowledge questions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePoor knowledge\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ethose who have scored less than 50% of the correct responses to preconception care knowledge questions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePreconception care\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAny interventions either advice or treatment, and lifestyle modification women received regarding components of preconception care before being pregnant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePreconception care utilization\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIf women received at least one type of intervention, either advice or treatment, and lifestyle modification care i.e., mentioned above at least once before being pregnant will be considered as mother utilized PCC.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrivate MCH Hospitals\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWomen\u0026rsquo;s and children\u0026rsquo;s specialty hospitals managed by individuals or groups, and which is not funded by the State, a public body or Non-governmental Organization.\u003c/p\u003e\n\u003ch3\u003eData Collection Procedures and Quality Assurance\u003c/h3\u003e\n\u003cp\u003eA data from pregnant woman following ANC was collected by a self-administered semi-structured questionnaire developed from previous published literature after modification to fit the research objective. The questionnaire was initially prepared in English and then translated into Amharic (local language) by different language experts of both languages and then to English to check its consistency. The questionnaire was used to elicit information regarding sociodemographic characteristics, knowledge about PCC, utilization of PCC prior to the current pregnancy and factors affecting the utilization of PCC. The data was administered by nurses. The questionnaire was pretested two weeks before the actual data collection with 5% of the sample size (20 pregnant women) in Zewditu Memorial Hospital in Addis Ababa and the necessary amendment was done on the questionnaire per pretest result. The overall activities of data collection were supervised and coordinated by the investigators. The collected data were checked for consistency, completeness, and relevance daily during the entire data collection by the principal investigator. After the data were collected from the respondents, it was translated back to English and analyzed using the statistical package SPSS version 26.\u003c/p\u003e\n\u003ch3\u003eData Processing and Analysis\u003c/h3\u003e\n\u003cp\u003eThe collected data were entered to Statistical Package for Social Science (SPSS) version 26.0 for analysis. Descriptive statistics were done to describe the data. Binary logistic regression analysis was employed to examine the statistical association between utilization of preconception care and every single independent variable. Variables that showed statistical significance during Bivariable analysis at (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0. 25) were entered into multivariable logistic regression to identify statistically significant variables. Multicollinearity was tested by using the variance inflation factor and tolerance test. The Hosmer-Lemeshow test was used to check the model fitness for analysis. Adjusted odds ratios (AOR) with 95% CI were estimated to assess the strength of associations and statistical significance was declared at a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Tables, figures, and text were used to present results.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e1. Sociodemographic Characteristics the Study Participants\u003c/h2\u003e \n\u003cp\u003eTable 1. The sociodemographic characteristics of study participants among Pregnant Women Attending ANC in Betsega and Hemen MCH Hospitals in Addis Ababa, Ethiopia,2022 (n-385)\u003c/p\u003e\n\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eStudy Hospitals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetsega Maternity and Children Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHemen Maternity and Children Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOrthodox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProfessional/technical/managerial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSales and Services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSkilled Manual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMonthly income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.5-60USD\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60-120USD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120-390USD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;390USD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e1: USD\u0026thinsp;=\u0026thinsp;United States dollar\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e2. Obstetric and Medical Characteristics of the Study Participants\u003c/h2\u003e \u003cp\u003eRegarding Obstetrics characteristics, 56% of the participants were multiparous followed by nulliparous (40.5%). With regard to ANC booking, 93.5% of them booked at gestational age less than 16weeks. In this study, 23.6% had history of prior obstetric problem(s) and abortion was the commonest which accounts 45.1% followed by still birth (18.7%). The detail obstetric and medical characteristics of study participants depicted in below (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\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 \u003cp\u003eObstetric and medical characteristics of pregnant women attending ANC at Betsega and Hemen MCH Hospitals, Addis Ababa, Ethiopia, 2022 n\u0026thinsp;=\u0026thinsp;385)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c2\" namest=\"c1\" rowspan=\"3\"\u003e \u003cp\u003eParity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNulliparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGrand multiparous (\u0026gt;\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"4\" nameend=\"c2\" namest=\"c1\" rowspan=\"5\"\u003e \u003cp\u003eGA\u003csup\u003e1\u003c/sup\u003e at booking of current pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1-2month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2-3month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3-4month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5month and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eObstetric problems in the previous pregnancies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"5\" nameend=\"c2\" namest=\"c1\" rowspan=\"6\"\u003e \u003cp\u003eAny obstetric problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAbortion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e45.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStillbirth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEarly neonatal death\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCongenital anomaly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePreterm birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003ePreexisting medical conditions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e87.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"3\" nameend=\"c2\" namest=\"c1\" rowspan=\"4\"\u003e \u003cp\u003eAny preexisting medical conditions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e45.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCardiac disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOthers (Epilepsy, SLE\u003csup\u003e2\u003c/sup\u003e, Liver disease, Thyroid disease)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e1: Gestational age 2: Systemic Lupus Erythematosus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3. Knowledge About Preconception Care\u003c/h2\u003e \u003cp\u003eThe finding of this study showed that 58% (223/385) of the participants had good knowledge on preconception care. Concerning the specific knowledge, 91% had ever heard about preconception care and 57.4% heard from health facility, while 20.8% heard via mass media. Family planning and Screening for medical conditions like diabetes, hypertension are mentioned as components of preconception care by 75.1% and 67.5% of the study participants, respectively. About 52.5% of them also mentioned screening for infectious disease like HIV, Syphilis, Hepatitis B virus as a components of preconception care. Furthermore, 76.4% of the pregnant participants know that a woman should stop using Alcohol and Smoking cigarette before conception and 68.1% of them know that a woman should have a healthy diet and use folic acid before conception (See Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e below).\u003c/p\u003e \u003cp\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 \u003cp\u003eParticipants Response for Knowledge Questions Regarding Preconception Care among Pregnant Women of Betsega and Hemen MCH Hospitals, AA, Ethiopia, 2022 (n\u0026thinsp;=\u0026thinsp;385).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariables (Knowledge Questions)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eResponse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eEver heard of Preconception care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e90.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eWhere did you hear about PCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHealth Facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eIn community\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMass media\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eInternet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eFamily planning is a component of PCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e289\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e75.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eImmunization is a component of PCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e54.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e45.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eScreening for medical conditions; diabetes, hypertension, asthma, epilepsy.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e260\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eStopping use of environmental toxins; Alcohol and Smoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e220\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eLifestyle changes; Healthy weight, Healthy diet, and Folic acid supplementation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eScreening for Infectious disease; HIV, Syphilis, Hepatitis B virus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eA woman should be on family planning during preconception period\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eA woman should be vaccinated before she conceives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eA woman should be screened for medical conditions like Hypertension and Diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e304\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e79.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eA woman should stop using Alcohol and Smoking cigarette before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eA woman should a healthy weight and use folic acid before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eA woman should be screened for familial diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eA woman should be screened for infectious diseases like HIV, HBV, Syphilis and Gonorrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e70.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4. Utilization of Preconception Care Services\u003c/h2\u003e \u003cp\u003eThe finding of this study showed that 40% of the study participants received preconception care before the current pregnancy (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). No significant differences were noted in the sociodemographic characteristics between the two MCH hospitals except for religion, the level of income, gestational age at booking and previous obstetric problems. Unsurprisingly, the utilization of preconception care is almost similar between the hospitals i.e.,37.3% and 42.7% for Betsega and Hemen MCH Hospital, respectively.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eIn 59.5% (229/385) of the study participants, their current pregnancy was intended and 56.9% (219/385) of the participants were using family planning before conception. The most frequently used types of preconception care services in this study were screening and management of chronic medical conditions 94.8% (146/154) and the most common screened medical condition was hypertension 88.9% (137/154), and the least utilized preconception service was immunization 33.1.4% (51/154) (see Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOther interesting findings in this study were \u003cb\u003e20.3% (78/385)\u003c/b\u003e of the pregnant were drinking alcohol before conception, of which forty-five of them still drinking alcohol until the end of the first trimester. Similarly, \u003cb\u003e1.8% (7/385)\u003c/b\u003e of the pregnant women were using cigarette smoking before conception and five of them were still smoking cigarette until the end first trimester. On the contrary, only 30.6% the pregnant women were advised on cessation of alcohol and smoking cigarette during preconception period (see Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\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 \u003cp\u003eUtilization of preconception care services among pregnant women in Betsega and Hemen MCH Hospitals, AA, Ethiopia,2022 (n\u0026thinsp;=\u0026thinsp;385)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePregnancy intention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFamily planning use before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eImmunization before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e86.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eScreened for any medical conditions before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eMedical conditions screened for before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSyphilis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnemia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdvised on the effects of alcohol and cigarette smoking on pregnancy before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWere you using Alcohol before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e20.3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWhen did you stop using Alcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2month before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 months after conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e57.7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWere you using Cigarette before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e1.8\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e378\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWhen did you to stop using Cigarette smoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2month before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 months after conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e71.4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eHow many months before conception did you start using folic acid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ea month before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2-3month before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3month after conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdvised to have a healthy weight before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e77.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e5. Partner support and Heath facility\u003c/h2\u003e \u003cp\u003eIn this study 362/385 (94%) of mothers make a decision about maternal health services with their partner (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). The most common supports provided by their partner were accompanying to the health facility 69.9% followed by psychological support 67% and the most common reasons cited by the mothers as problems when they want to start preconception care were long distance from health facility 25.7% and availability of health care provider 15.1%. In addition, 75.3% of the pregnant women cited the cost of preconception care services as fair. The most common reasons for not receiving PCC among the pregnant women who had not received it were lack of awareness of the availability of the services 64.8% followed by because their pregnancy wasn\u0026rsquo;t expected 28.1% and only 11.7% not accepted the importance of preconception care (see Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHealth Facility and Parental Support among Pregnant Women in Betsega and Hemen MCH Hospitals(n\u0026thinsp;=\u0026thinsp;385)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDecision maker regarding utilization of reproductive health services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePartner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJoint\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e362\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eThe type of support your partner offered during preconception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAccompanying to the health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinancial support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychological support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpiritual support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eWere the following problems when you want to receive preconception care services?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLong distance from health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAvailability of health care providers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePerception of being low risk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTransport money\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHow affordable is the cost?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpensive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e290\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCheap\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eIf you did not receive any form of PCC services, what do you think is the reason?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot aware that the service is available in the country\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe pregnancy was not expected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIt is not important before conception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e6. Determinants of Preconception Care Utilization\u003c/h2\u003e \u003cp\u003eThe strength of association between independent variables and outcome variable (preconception care utilization) were measured using odds ratio and 95% confidence interval using binary logistics regression model. Accordingly, maternal age, educational status, marital status, occupation, monthly income, knowledge on preconception care, parity, family planning use, intended pregnancy, obstetric problem in previous pregnancy and preexisting medical condition had a p-value of \u0026le; 0.25 in the bivariable analysis and taken into the final model for multivariable analysis. In multivariable logistic regression analysis, occupation, knowledge on preconception care, family planning use, intended pregnancy, obstetric problem in previous pregnancy and preexisting medical condition were significantly associated with utilization of PCC at p-value of \u0026le; 0.05(see Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePregnant woman whose occupation is professional/technical/managerial were 4.3 times more likely to receive preconception care when compared to the housewives (AOR\u0026thinsp;=\u0026thinsp;4.3, 95%CI\u0026thinsp;=\u0026thinsp;1.13, 16.33). P\u0026thinsp;\u0026lt;\u0026thinsp;0.032).\u003c/p\u003e \u003cp\u003eThose pregnant women who had good knowledge on PCC were 3.5 times more likely to utilize PCC than those having poor knowledge (AOR\u0026thinsp;=\u0026thinsp;3.5, 95%CI\u0026thinsp;=\u0026thinsp;1.92, 6.53, P\u0026thinsp;\u0026lt;\u0026thinsp;0.000).\u003c/p\u003e \u003cp\u003ePregnant mothers who had an unintended pregnancy were 90% less likely to utilize PCC compared to whose pregnancy were intended and those using family planning before conception were 3.9 times more likely to seek preconception care than mothers who weren\u0026rsquo;t using family planning before conception (AOR\u0026thinsp;=\u0026thinsp;0.10, 95%CI\u0026thinsp;=\u0026thinsp;0.03,0.42, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001).and (AOR\u0026thinsp;=\u0026thinsp;3.9, 95%CI\u0026thinsp;=\u0026thinsp;1.20, 12.60, P\u0026thinsp;\u0026lt;\u0026thinsp;0.023).\u003c/p\u003e \u003cp\u003eLastly, those having pre-existing medical disease(s) and obstetric problem(s) in previous pregnancy were 8.4 and 3.2 times more likely to utilize PCC than who had not (AOR\u0026thinsp;=\u0026thinsp;8.4, 95%CI\u0026thinsp;=\u0026thinsp;2.83, 24.74, P\u0026thinsp;\u0026lt;\u0026thinsp;0.000) and (AOR\u0026thinsp;=\u0026thinsp;3.2, 95%CI\u0026thinsp;=\u0026thinsp;1.55, 6.50, P\u0026thinsp;\u0026lt;\u0026thinsp;0.002).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariable and Multivariable Logistic Regression Analysis of Factors determining Utilization of PCC among Pregnant Women having ANC in private setting, AA, 2022 (n\u0026thinsp;=\u0026thinsp;385)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePCC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.4(0.67, 2.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.690\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8(0.26, 2.44)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.2(0.95, 4.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.656\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.7(0.23, 2.54)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.471\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.5(0.52, 4.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.946\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.0(0.22, 4.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.6(1.02, 6.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.829\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.2(0.28, 4.91)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.0(0.65,14.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.9(0.25,14.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.6(0.48, 27.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.5(0.07,31.41)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessional/Technical/ Managerial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.3(1.66, 11.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.032\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e4.3(1.13, 16.33)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSales and Services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.082\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.3(0.90, 5.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.2(0.85, 12.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkilled Manual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0(0.10, 11.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.874\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.8(0.001,2592)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousewives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly Income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1955-3130ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.33(0.08,1.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.2(0.03, 1.54)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3130- 6260ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.48(0.22,1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.692\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.2(0.40, 3.93)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6260-20,335ETB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.73(0.45,1.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.805\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.1(0.55, 2.17)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;20,335ETB)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of knowledge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.5(3.42, 8.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e3.5(1.92, 6.53)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor Knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eParity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNulliparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.7(0.5, 1.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.8(0.45, 1.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.993\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0(0.35, 2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.0(0.63,14.12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePregnancy Intention\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.05(0.03, 0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.1(0.03, 0.42)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFamily planning use before conception\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19(10.4, 35.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.023\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e3.9(1.20,12.60)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eObstetric problems in the previous pregnancies\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.1(2.50, 6.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e3.2(1.55, 6.50)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHave any preexisting medical conditions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.5(2.8, 11.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e8.4(2.83, 24.74)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003ePreconception care (PCC) an approach to optimize pregnancy outcomes which is crucial for many Sub-Saharan African countries, such as Ethiopia, where maternal and perinatal mortality remains alarmingly high.\u003c/p\u003e \u003cp\u003eThis study found that the prevalence of preconception care utilization among the study participants was considerably low, i.e., 40%. This is similar with findings from China(40%)(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), Malaysia (44%)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)and Kenya(35.1%)(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The study finding showed higher uptake of preconception care compared to studies done in Nigeria by Ekem et.al 10.3% and Adeyemo et.al 18.8%(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), Siri Lanka by Patabendige M. et.al 27.2% (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)and community-based studies in Ethiopia (Debre Birhan Town 13.4%,Mekelle City 18.2%, West Guji 22.3%)(\u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). The reason for the difference could be due to the different study setting and difference in the sociodemographic characteristics of the study participants.\u003c/p\u003e \u003cp\u003eThe most common types of preconception services utilized by the mothers were screening and management of chronic medical conditions (94.8%) and the least utilized preconception service was Immunization 33.1%. This finding different from a study done Mekelle city in which the most common utilized component of PCC was micronutrient supplementation (i.e., iron, folic acid) (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn addition, this study found that pregnant woman whose occupation is professional/technical/managerial were 4.3 times more likely to receive preconception care when compared to the housewives (AOR\u0026thinsp;=\u0026thinsp;4.3, 95%CI\u0026thinsp;=\u0026thinsp;1.13, 16.33, P\u0026thinsp;\u0026lt;\u0026thinsp;0.032). This is consistent with the study done in France(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) and Nigeria(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). This might be because of individuals working at professional/technical/managerial position are more likely to have better knowledge regarding preconception care and might have also better access to information than the housewives.\u003c/p\u003e \u003cp\u003eAwareness and knowledge were significantly associated with utilization of preconception care in several studies(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). In this study 90.9% (350/385) of the respondents ever heard of preconception care. The main source of information was healthcare providers in 62.6% (221/350), mass media in 22.7% (80/350), community in 12.7% (45/350) and internet 2% (7/350). Similarly, 58% (223/385) of the participants had good knowledge on preconception care. This finding is different from studies done in Ethiopia(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) and Nigeria(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) which showed lower awareness and knowledge about preconception care among pregnant women which might be due the different study settings and different sociodemographic background of the study population.\u003c/p\u003e \u003cp\u003eIn this study pregnant women who had good knowledge about PCC were 3.5 times more likely to utilize PCC when compared to their counterparts who had poor knowledge about preconception care (AOR\u0026thinsp;=\u0026thinsp;3.5, 95%CI\u0026thinsp;=\u0026thinsp;1.92, 6.53, P\u0026thinsp;\u0026lt;\u0026thinsp;0.000). This finding is consistent with studies done in Hosanna Town, which showed 82% reduced odds of utilizing preconception care among women who had poor knowledge on preconception care than their counterparts (AOR\u0026thinsp;=\u0026thinsp;0.18; 95% Cl (0.084, 0.379)(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and West Guji which also showed 2.43 times odds of utilizing PCC among women having good knowledge good compared to their counterparts (AOR\u0026thinsp;=\u0026thinsp;2.34 95% CI, 1.05, 5.28)(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Study in Malaysia(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e),also showed positive association between good knowledge about preconception care and PCC utilization. This might be because good knowledge about preconception care help them know details about the importance of service. In addition to that, knowledge about PCC might improve attitudes towards PCC that might in turn improve the utilization of preconception care.\u003c/p\u003e \u003cp\u003eSimilarly, pregnant mothers who had an unintended pregnancy were 90% less likely to utilize PCC compared to whose pregnancy were intended and those using family planning before conception were 3.9 times more likely to seek preconception care than mothers who weren\u0026rsquo;t using family planning before conception (AOR\u0026thinsp;=\u0026thinsp;0.10, 95%CI\u0026thinsp;=\u0026thinsp;0.03,0.42, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001).and (AOR\u0026thinsp;=\u0026thinsp;3.9, 95%CI\u0026thinsp;=\u0026thinsp;1.20, 12.60, P\u0026thinsp;\u0026lt;\u0026thinsp;0.023). This finding is consistent with studies done in Hosanna Town(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) which showed that the odds of utilizing preconception care in women who had used family planning before current pregnancy were 2.45 times higher than those women who had not used family planning before current pregnancy (AOR\u0026thinsp;=\u0026thinsp;2.45; 95% Cl (1.270, 4.741).\u003c/p\u003e \u003cp\u003eAnother study in Los Angeles(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) also showed among women with adverse pregnancy outcomes, having unintended pregnancy was associated with 70% lower odds of not utilizing preconception care(AOR\u0026thinsp;=\u0026thinsp;0.332;95%CI (0.283, 0.391). This is because those pregnant mothers who planned their pregnancy are more likely to visit health facility to seek family planning services hence might have broader opportunities to receive preconception counselling services.\u003c/p\u003e \u003cp\u003eFurthermore, pregnant women having preexisting medical disease(s) and obstetric problem(s) in previous pregnancy were 8.4 and 3.2 times more likely to utilize PCC than who had not (AOR\u0026thinsp;=\u0026thinsp;8.4, 95%CI\u0026thinsp;=\u0026thinsp;2.83, 24.74, P\u0026thinsp;\u0026lt;\u0026thinsp;0.000) and (AOR\u0026thinsp;=\u0026thinsp;3.2, 95%CI\u0026thinsp;=\u0026thinsp;1.55, 6.50, P\u0026thinsp;\u0026lt;\u0026thinsp;0.002). These findings are consistent with studies done in Malaysia(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e),Los Angeles (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) and Mekelle City(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). It can be assumed that these patients are more likely to have frequent health facility visits hence more likely to have adequate information regarding the effect of their medical diseases on pregnancy. In the same line, those pregnant mothers with previous obstetric problem(s) are more likely to be concerned and might have heightened risk awareness compared to who had not.\u003c/p\u003e \u003cp\u003eMoreover, about 75% of the study participants found no problem in accessing health facilities. This is similar to studies done in Hosanna Town and West Guji majority of women found no problem in accessing health facilities(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). In addition, 75.3% of the pregnant women cited the cost of preconception care services as fair.\u003c/p\u003e \u003cp\u003eLastly, among the pregnant mothers who did not receive PCC services when asked their reason for not receiving the care, two-thirds stated they were not aware that the service is available, one-third stated their pregnancy was not expected and about 11.7% think it is not important to them. This finding is similar to studies done in Los Angeles (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) which found that the common reason cited for not receiving PCC were not having pregnancy intended. This shows that even though the awareness and knowledge is good and only few of them had poor attitude toward preconception care, only less than half utilized PCC services. The plausible explanation for the low uptake in this study could be lack of awareness regarding the availability of the services and having unintended pregnancy.\u003c/p\u003e\n\u003ch3\u003eStrength of the study\u003c/h3\u003e\n\u003cp\u003eIt is one of the very few studies conducted in Ethiopia in the area of PCC in private setting.\u003c/p\u003e \u003cp\u003eIt has given some information about the prevalence of alcohol intake and smoking cigarette during pregnancy in Ethiopia.\u003c/p\u003e\n\u003ch3\u003eLimitation of the study\u003c/h3\u003e\n\u003cp\u003eRecall bias is a limitation of the study due to the nature of problem under the study requiring the potential ability of respondents to remember information retrospectively.\u003c/p\u003e \u003cp\u003eSelection bias is also a limitation as the study hospitals were chosen by the convenience sampling method.\u003c/p\u003e \u003cp\u003eThe impact of husband\u0026rsquo;s educational attainment on PCC utilization was not included.\u003c/p\u003e \u003cp\u003eCertain components of preconception care were not studied.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study found that the utilization of preconception care in the private institution is still low i.e., only 40%. Occupation, level of knowledge, having intended pregnancy, history of family planning use before conception, having obstetric problem(s) in previous pregnancy and having pre-existing medical condition(s) were independently associated with preconception care utilization.\u003c/p\u003e \u003cp\u003eLack of awareness regarding the availability of the PCC services and having unintended pregnancy were the obstacles for not receiving PCC.\u003c/p\u003e"},{"header":"Recommendations","content":"\u003cp\u003eHealth education regarding the importance and the availability of PCC services should be given to women of reproductive age.\u003c/p\u003e \u003cp\u003eInterventions aimed at increasing the proportion of intended pregnancies will also be critical to promote the utilization of preconception care services.\u003c/p\u003e"},{"header":"List Of Abbreviations","content":" \u003cp\u003eAA Addis Ababa\u003c/p\u003e \u003cp\u003eAKUH Aga Khan University Hospital\u003c/p\u003e \u003cp\u003eANC Antenatal Care\u003c/p\u003e \u003cp\u003eAOR Adjusted Odds Ratio\u003c/p\u003e \u003cp\u003eBMCH Betsega Maternity and Children Hospital\u003c/p\u003e \u003cp\u003eCI Confidence Interval\u003c/p\u003e \u003cp\u003eHBV Hepatitis B Virus\u003c/p\u003e \u003cp\u003eHIV Human Immunodeficiency Virus\u003c/p\u003e \u003cp\u003eHMCH Hemen Maternity and Children Hospital\u003c/p\u003e \u003cp\u003eGA Gestational Age\u003c/p\u003e \u003cp\u003eIOM Institute of Medicine\u003c/p\u003e \u003cp\u003eMCH Maternal and Child Health\u003c/p\u003e \u003cp\u003eMLFH Maragua Level Four Hospital\u003c/p\u003e \u003cp\u003eOR Odds Ratio\u003c/p\u003e \u003cp\u003ePCC Preconception Care\u003c/p\u003e \u003cp\u003ePI Principal Investigator\u003c/p\u003e \u003cp\u003eSLE Systemic Lupus Erythematosus\u003c/p\u003e \u003cp\u003eSPSS Statistical Package for Health sciences\u003c/p\u003e \u003cp\u003eWHO World Health Organization\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by ethical review board of Department of Obstetrics and Gynecology, Addis Ababa University in accordance with Declaration of Helsinki and official letter of permission was obtained from each private Hospital\u0026rsquo;s administration before data collection. Before participating in the study, the purpose of the study was explained to the study participants and written informed consent was obtained. The collected information was kept confidential through coding. \u0026nbsp;All methods were carried out in accordance with relevant international and local ethical guidelines for research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dataset generated during/or analyzed during the current study are not publicly available due to the papers written using this dataset have not been published but are available from corresponding authors on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe the authors declare that we didn\u0026rsquo;t have any competing interests in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no support or funding to report.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization of the study was done A.G with help of A.B and S.K. \u0026nbsp; A.B and S.K\u0026nbsp;played supervision role during the study processes. A.G carried out the investigation and formal analysis of the data with help of A.B. A.G prepared the original draft of manuscript. \u0026nbsp;All the authors contributed in reviewing and editing of the manuscript. All authors have read and agreed on the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like acknowledge Addis Ababa University College of health science for allowing us to conduct this study. We would also like to thank the participants and hospital administrators for their cooperation.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCenter for Desease Control and Prevention. Morbidity and Mortality Weekly Report Recommendations and Reports Recommendations to Improve Preconception Health and Health Care-United States A Report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care Centers for. 2006;55. \u003c/li\u003e\n\u003cli\u003eShawe J, Steegers EAP. Preconception Health and Care: A Life Course Approach. Preconception Health and Care: A Life Course Approach. 2020. \u003c/li\u003e\n\u003cli\u003eUSAID. Ethiopia Fact sheet Maternal and Child Health. Nurs Midwifery Board Aust. 2019;035(September):1\u0026ndash;3. \u003c/li\u003e\n\u003cli\u003eWhy Maternal Mortality Is So High in Sub-Saharan Africa [Internet]. [cited 2023 Apr 7]. Available from: https://www.globalcitizen.org/en/content/maternal-mortality-sub-saharan-africa-causes/\u003c/li\u003e\n\u003cli\u003eMamo K, Siyoum M, Birhanu A. Teenage pregnancy and associated factors in Ethiopia: a systematic review and meta-analysis. Int J Adolesc Youth [Internet]. 2021;26(1):501\u0026ndash;12. Available from: https://doi.org/10.1080/02673843.2021.2010577\u003c/li\u003e\n\u003cli\u003eAlene M, Yismaw L, Berelie Y, Kassie B, Yeshambel R, Assemie MA. Prevalence and determinants of unintended pregnancy in Ethiopia: A systematic review and meta-analysis of observational studies. PLoS One [Internet]. 2020;15(4):1\u0026ndash;15. Available from: http://dx.doi.org/10.1371/journal.pone.0231012\u003c/li\u003e\n\u003cli\u003eDing Y, Li X, Xie F, Yang Y. Survey on the Implementation of Preconception Care in. 2015;492\u0026ndash;500. \u003c/li\u003e\n\u003cli\u003eAbu Talib R, Idris IB, Sutan R, Ahmad N, Abu Bakar N. Patterns of pre-pregnancy care usage among reproductive age women in kedah, malaysia. Iran J Public Health. 2018;47(11):1694\u0026ndash;702. \u003c/li\u003e\n\u003cli\u003ePatabendige M, Goonewardene IMR. Preconception care received by women attending antenatal clinics at a Teaching Hospital in Southern Sri Lanka. 2013;(March):3\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eEkem NN, Lawani LO, Onoh RC, Iyoke CA, Ajah LO, Onwe EO, et al. Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria. J Obstet Gynaecol (Lahore) [Internet]. 2018;38(6):739\u0026ndash;44. Available from: https://doi.org/10.1080/01443615.2017.1405922\u003c/li\u003e\n\u003cli\u003eAyele AD, Belay HG, Kassa BG, Worke MD. Knowledge and utilisation of preconception care and associated factors among women in Ethiopia: systematic review and meta-analysis. Reprod Health [Internet]. 2021;18(1):1\u0026ndash;15. Available from: https://doi.org/10.1186/s12978-021-01132-9\u003c/li\u003e\n\u003cli\u003eOkemo J, Temmerman M, Mwaniki M, Kamya D. Preconception care among pregnant women in an urban and a rural health facility in Kenya: A quantitative study. Int J Environ Res Public Health. 2020;17(20):1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eAdeyemo AA, Bello OO. Preconception care : What women know , think and do. 2021;20(February):18\u0026ndash;26. \u003c/li\u003e\n\u003cli\u003eDemisse TL, Aliyu SA, Kitila SB, Tafesse TT, Gelaw KA, Zerihun MS. Beebe K, Lee K, Carrieri-Kohlman V, Humphreys J. The effects of childbirth self-efficacy and anxiety during pregnancy on prehospitalization labor.J Obstet Gynecol Neonatal Nurs. 2007;36(5):410\u0026ndash;8. 2019;1\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eAsresu TT, Hailu D, Girmay B, Abrha MW, Weldearegay HG. Mothers\u0026rsquo; utilization and associated factors in preconception care in northern Ethiopia: A community based cross sectional study. BMC Pregnancy Childbirth. 2019;19(1):1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eAmaje E, Fikrie A, Utura T. Utilization of Preconception Care and Its Associated Factors among Pregnant Women of West Guji Zone, Oromia, Ethiopia, 2021: A Community-Based Cross-Sectional Study. Heal Serv Res Manag Epidemiol. 2022;9:1\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eParadis S, Ego A, Bosson JL. Preconception care among low-risk mothers in a French perinatal network: Frequency of utilization and factors associated. J Gynecol Obstet Hum Reprod [Internet]. 2017;46(7):591\u0026ndash;6. Available from: http://dx.doi.org/10.1016/j.jogoh.2017.05.002\u003c/li\u003e\n\u003cli\u003eEzegwui HU, Dim C, Dim N, Ikeme AC. Preconception care in South Eastern Nigeria. J Obstet Gynaecol (Lahore). 2008;28(8):765\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eAyalew Y, Mulat A, Dile M, Simegn A. Women\u0026rsquo;s knowledge and associated factors in preconception care in adet, west gojjam, northwest Ethiopia: A community based cross sectional study. Reprod Health [Internet]. 2017;14(1):1\u0026ndash;10. Available from: http://dx.doi.org/10.1186/s12978-017-0279-4\u003c/li\u003e\n\u003cli\u003eWegene MA, Gejo NG, Bedecha DY, Kerbo AA, Hagisso SN, Damtew SA. Utilization of preconception care and associated factors in Hosanna Town, Southern Ethiopia. PLoS One [Internet]. 2022;17(1 January):1\u0026ndash;16. Available from: http://dx.doi.org/10.1371/journal.pone.0261895\u003c/li\u003e\n\u003cli\u003eBatra P, Higgins C, Chao SM. Previous Adverse Infant Outcomes as Predictors of Preconception Care Use : An Analysis of the 2010 and 2012 Los Angeles Mommy and Baby ( LAMB ) Surveys. Matern Child Health J. 2016;20(6):1177\u0026ndash;84. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Preconception care, Private MCH Hospitals, Addis Ababa, Determinants, Utilization","lastPublishedDoi":"10.21203/rs.3.rs-2842453/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2842453/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003e Regardless of its benefit in promoting maternal health and the health of her developing fetus, and little is known about preconception care practice in Ethiopia. The purpose of this study, therefore, is to determine the utilization of preconception health care services and its determinants among women following ANC in Private MCH Hospitals in Addis Ababa.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA Hospital based cross-sectional study was conducted from April 1 to April 30,2022 among 385 women attending ANC in Private MCH Hospitals. Data were collected by a pretested self-administered semi-structured questionnaire. To identify the determinants associated with the utilization of preconception care bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratios (AOR) with 95% CI were estimated to assess the strength of associations and statistical significance was declared at a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe utilization of PCC among the pregnant mothers according to our study was 40%. Professional/technical/managerial occupation (AOR\u0026thinsp;=\u0026thinsp;4.3, 95%CI\u0026thinsp;=\u0026thinsp;1.13, 16.33), good knowledge on PCC (AOR\u0026thinsp;=\u0026thinsp;3.5, 95%CI\u0026thinsp;=\u0026thinsp;1.92, 6.53),having unintended pregnancy (AOR\u0026thinsp;=\u0026thinsp;0.1, 95%CI\u0026thinsp;=\u0026thinsp;0.03, 042), history of family planning use before conception (AOR\u0026thinsp;=\u0026thinsp;3.9, 95%CI\u0026thinsp;=\u0026thinsp;1.20, 12.60), having pre-existing medical disease(s) (AOR\u0026thinsp;=\u0026thinsp;8.4, 95%CI\u0026thinsp;=\u0026thinsp;2.83, 24.74) and having obstetric problem(s) in previous pregnancies (AOR\u0026thinsp;=\u0026thinsp;3.2, 95%CI\u0026thinsp;=\u0026thinsp;1.55, 6.50) were significantly associated with preconception care utilization.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis study found out that the utilization of preconception care in the private MCH Hospitals is still low i.e., only 40%. Occupation, level of knowledge, having intended pregnancy, history of family planning use before conception, having obstetric problem(s) in previous pregnancy and having pre-existing medical condition(s) were independently associated with preconception care utilization. Lack of awareness about the availability of the services and having unintended pregnancy were the main reasons for not utilizing the PCC services.\u003c/p\u003e","manuscriptTitle":"Utilization of Preconception Care and Its Determinants Among Pregnant Women Attending ANC in Private MCH Hospitals in Addis Ababa, Ethiopia: A Cross Sectional Descriptive Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-05-11 22:11:35","doi":"10.21203/rs.3.rs-2842453/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-06-24T11:58:03+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-06-05T09:06:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"3f9f672c-3922-408c-bc21-a9f883fc833b","date":"2023-06-05T05:29:12+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-06-04T22:50:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-05-09T12:58:32+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2023-05-09T08:17:15+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-05-09T08:09:20+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2023-04-20T17:46:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"194491fe-5894-475b-adb8-ef23a5375a50","owner":[],"postedDate":"May 11th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-09-11T15:11:12+00:00","versionOfRecord":{"articleIdentity":"rs-2842453","link":"https://doi.org/10.1186/s12884-023-05955-1","journal":{"identity":"bmc-pregnancy-and-childbirth","isVorOnly":false,"title":"BMC Pregnancy and Childbirth"},"publishedOn":"2023-09-08 15:09:47","publishedOnDateReadable":"September 8th, 2023"},"versionCreatedAt":"2023-05-11 22:11:35","video":"","vorDoi":"10.1186/s12884-023-05955-1","vorDoiUrl":"https://doi.org/10.1186/s12884-023-05955-1","workflowStages":[]},"version":"v1","identity":"rs-2842453","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2842453","identity":"rs-2842453","version":["v1"]},"buildId":"iFTdqyg4nuje_uAy1AHro","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}