# Factors influencing preconception care awareness and knowledge among women in Africa: a systematic review

## TL;DR

This paper reviews factors affecting preconception care awareness and knowledge among African women, highlighting education, socioeconomic status, and healthcare access as key influences.

## Contribution

The study systematically synthesizes evidence on PCC awareness and knowledge in Africa, identifying risk and protective factors not previously emphasized in prior reviews.

## Key findings

- PCC awareness ranged from 5.9% in Ethiopia to 91% in Tanzania, with knowledge levels varying from 11% in Sudan to 70% in Tanzania.
- Low education, poor socioeconomic status, and limited healthcare access were linked to lower PCC awareness and knowledge.
- Higher education, economic stability, and frequent antenatal care visits were protective factors for better PCC awareness and knowledge.

## Abstract

Preconception care (PCC) plays a critical role in enhancing maternal and neonatal health by addressing risk factors before pregnancy. Most existing reviews focus on PCC outcomes such as utilization with limited attention to factors influencing PCC awareness and knowledge. This review addressed this gap by synthesizing evidence on PCC awareness and knowledge levels and by examining the associated risk and protective factors among women in Africa.

The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five main databases (PubMed Central, African Journals Online, Web of Science, Scopus, and Journal Storage) were searched in March 2025, and 27 articles met the eligibility criteria for inclusion. The Joanna Briggs Institute critical appraisal checklist was used to assess the methodological quality of the studies. Data were analyzed using a narrative review approach to evaluate awareness and knowledge levels, as well as the risk and protective factors influencing PCC.

Awareness levels of PCC ranged from 5.9% in Ethiopia to 91% in Tanzania, while knowledge levels varied from 11% in Sudan to 70% in Tanzania. Low awareness and knowledge were associated with risk factors such as low education, poor socioeconomic status, limited healthcare access, lack of antenatal care (ANC), and adverse pregnancy histories. Protective factors contributing to higher PCC awareness and knowledge included higher educational attainment, greater economic stability, more frequent ANC visits, greater media exposure, and improved access to counseling and support services.

Despite encouraging progress in some regions, significant gaps in PCC awareness and knowledge remain across African countries, particularly in low-resource settings. Bridging these gaps will require context-specific educational strategies, policy support, and expanded access to quality healthcare services tailored to African health systems.

https://doi.org/10.17605/OSF.IO/VPWZG