‘The silent struggles’: a qualitative exploration of factors influencing non-implementation of preconception care in Agogo Presbyterian Hospital

Abstract

Introduction: Preconception care (PCC) is an important health promotion intervention aimed at optimising the health of women of reproductive age before pregnancy to reduce maternal mortality. However, the quest for its implementation within the healthcare system remains a significant challenge in Ghana. Understanding the views of healthcare professionals and hospital administrative managers is vital for identifying feasible strategies to address challenges. The study sought to explore factors influencing the non-implementation of PCC interventions at Agogo Presbyterian Hospital. Methods: A qualitative exploratory approach was used. 10 healthcare professionals and three hospital administrative managers with experience in providing maternal healthcare services and the ability to provide information on maternal health issues at Agogo Presbyterian Hospital were interviewed. Data analysis was conducted using Braun and Clarke's thematic content analysis approach. Result: The study identified key barriers to PCC implementation within the healthcare system. The participants described knowledge gaps among care providers, excessive workload, role confusion, the unavailability of PCC guidelines and infrastructure, inadequate human and financial resources and a lack of support and motivation of staff as hurdles to PCC implementation in the healthcare system. They suggested the need for capacity building of human resources, specific PCC guidelines, job descriptions and sustainable funding mechanisms to strengthen the healthcare system for effective PCC implementation. Conclusion: The challenges revealed by this study provide policymakers and healthcare institutions with insights to address the implicit barriers in the healthcare system to promote the practice of PCC as part of maternal healthcare services to ensure optimal maternal health before conception and to decrease maternal mortality rates.