Family Planning Programs – An Opportunity to Integrate Preconception Health Services into Primary Health Care

Dumitru Siscanu, Sarah Verbiest, Corina Iliadi-Tulbure, Anait Yu. Marianian, Patricia Chico Aldama, Iurii Arian, Viorica Chihai

International Journal of Biomedicine. 2021;11(4):467-472.
DOI: 10.21103/Article11(4)_PV
Originally published December 10, 2021


A life-course approach to enhancing maternal and child health by improving parental health prior to conception is gaining international interest. Healthcare providers and researchers are seeking effective ways to increase women’s and men’s access to preconception care, especially through primary care. At the same time, preconception health includes conversations about pregnancy planning (or avoidance), which is a part of FP services. Unfortunately, “family planning” has the same meaning as “contraception” for many people at the moment, which is too simplistic because there are multiple aspects of preconception health and well-being. Expanding the understanding of preconception health as inclusive of FP and primary care has the potential to increase access to this important care while respecting sexual and reproductive rights, according to a couple’s reproductive plans.
Respecting the sexual and reproductive rights of the population requires that FP programs be focused not only on contraception but, equally, on preconception care.

preconception health • preconception care • family planning • contraception • primary care • reproductive health
  1. Shishcanu D, Marianian AY, Iliadi-Tulbure C. Preconceptional care: opportunities and challenges. Acta Biomedica Scientifica. 2018;3(3):69-74.    
  2. Siscanu D, Iliadi-Tulbure C, Bolun A, Chihai V, Gurau V. Suggestions about population perception on preconceptional care in Republic of Moldova. Buletin de Perinatologie. 2018;3(79):91-94.
  3. Meeting to Develop a Global Consensus on Preconception Care to Reduce Maternal and Childhood Mortality and Morbidity. World Health Organization Headquarters, Geneva 6–7 February 2012; 67p. Meeting report.         
    Available from:
  4. Pre-conception – advice and management. Clinical Knowledge Summaries. 2017. Available from: (accessed May 6th 2021).
  5. van der Zee B, de Beaufort ID, Steegers EA, Denktas S. Perceptions of preconception counselling among women planning a pregnancy: a qualitative study. Fam Pract. 2013 Jun;30(3):341-6. doi: 10.1093/fampra/cms074.
  6. Preconception care: Maximizing the gains for maternal and child health. World Health Organization. Geneva. 2013.   Available from:
  7. Lammers Cr. A New Focus on Preconception Healthcare and the Life Course Theory of Health. Journal of Community and Public Health Nursing. 2018;4(2):216. doi: 10.4172/2471-9846.1000216.
  8. van Voorst S, Plasschaert S, de Jong-Potjer L, Steegers E, Denktaş S. Current practice of preconception care by primary caregivers in the Netherlands. Eur J Contracept Reprod Health Care. 2016 Jun;21(3):251-8. doi: 10.3109/13625187.2016.1154524.
  9. Pustotina OA. [Preconception Preparation]. Meditsinskiy Sovet=Medical Council. 2017;13:64-70. doi: 10.21518/2079-701X-2017-13-64-70. [Article in Russian].
  10. American Academy of Family Physicians. Preconception care (posi­tion paper). 2016. Available from:
  11. Steel A, Lucke J, Reid R, Adams J. A systematic review of women's and health professional's attitudes and experience of preconception care service delivery. Fam Pract. 2016 Dec;33(6):588-595. doi: 10.1093/fampra/cmw094. 
  12. Mazza D, Chapman A, Michie S. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study. BMC Health Serv Res. 2013 Jan 31;13:36. doi: 10.1186/1472-6963-13-36.
  13. Shannon GD, Alberg C, Nacul L, Pashayan N. Preconception healthcare delivery at a population level: construction of public health models of preconception care. Matern Child Health J. 2014 Aug;18(6):1512-31. doi: 10.1007/s10995-013-1393-8.
  14. Ukoha WC, Dube M. Primary health care nursing students' knowledge of and attitude towards the provision of preconception care in KwaZulu-Natal. Afr J Prim Health Care Fam Med. 2019 Nov 12;11(1):e1-e8. doi: 10.4102/phcfm.v11i1.1916. 
  15. Lang AY, Boyle JA, Fitzgerald GL, Teede H, Mazza D, Moran LJ, Harrison C. Optimizing preconception health in women of reproductive age. Minerva Ginecol. 2018 Feb;70(1):99-119. doi: 10.23736/S0026-4784.17.04140-5.
  16. Hussein N. Preconception assessment of reproductive genetic risk in primary care. Thesis submitted to the University of Nottingham for the degree of Doctor of Philosophy. December 2016. Available from:       
  17. Floyd RL, Johnson KA, Owens JR, Verbiest S, Moore CA, Boyle C. A national action plan for promoting preconception health and health care in the United States (2012-2014). J Womens Health (Larchmt). 2013 Oct;22(10):797-802. doi: 10.1089/jwh.2013.4505. 
  18. Gavin L, Moskosky S, Carter M, Curtis K, Glass E, Godfrey E, Marcell A, Mautone-Smith N, Pazol K, Tepper N, Zapata L; Centers for Disease Control and Prevention (CDC). Providing quality family planning services: Recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep. 2014 Apr 25;63(RR-04):1-54. 
  19. Allan HT, Mounce G, Crespo E, Shawe J. Preconception care for infertile couples: Nurses' and midwives' roles in promoting better maternal and birth outcomes. J Clin Nurs. 2018 Dec;27(23-24):4411-4418. doi: 10.1111/jocn.14586. 
  20. Family Planning. A global handbook for providers. Evidence-based guidance developed through worldwide collaboration, 3rd edition, 2018. Available from:;jsessionid=027939A21D681CBFFC67C66E0DBB28FD?sequence=1
  21. Ensuring human rights in the provision of contraceptive information and services. Guidance and recommendations. WHO. 2014.  
    Available from: (accessed May 6th 2021).
  22. Siscanu D, Iliadi-Tulbure C, Marianian AY, Aldama PC, Verbiest S, Dumbraveanu I, et al. “PerConcept” Study: Provider Opinions about Integrating Preconception Care into Family Planning Services. Public Health, Economy and Management in Medicine, 2021;91(4).
  23. Frayne DJ. Preconception Care Is Primary Care: A Call to Action. Am Fam Physician. 2017 Oct 15;96(8):492-494. 
  24. Srinivasulu S, Falletta KA, Bermudez D, Almonte Y, Baum R, Coriano M, Grosso A, Iglehart K, Mota C, Rodriguez L, Taveras J, Tobier N, Garbers SV. Primary care providers' responses to pregnancy intention screening challenges: community-based participatory research at an urban community health centre. Fam Pract. 2019 Nov 18;36(6):797-803. doi: 10.1093/fampra/cmz027. 
  25. Bortolus R, Oprandi NC, Rech Morassutti F, Marchetto L, Filippini F, Agricola E, Tozzi AE, Castellani C, Lalatta F, Rusticali B, Mastroiacovo P. Why women do not ask for information on preconception health? A qualitative study. BMC Pregnancy Childbirth. 2017 Jan 5;17(1):5. doi: 10.1186/s12884-016-1198-z. 
  26. Callegari LS, Ma EW, Schwarz EB. Preconception care and reproductive planning in primary care. Med Clin North Am. 2015 May;99(3):663-82. doi: 10.1016/j.mcna.2015.01.014. 
  27. Dean SV, Lassi ZS, Imam AM, Bhutta ZA. Preconception care: promoting reproductive planning. Reprod Health. 2014 Sep 26;11 Suppl 3(Suppl 3):S2. doi: 10.1186/1742-4755-11-S3-S2.
  28. St Fleur M, Damus K, Jack B. The future of preconception care in the United States: multigenerational impact on reproductive outcomes. Ups J Med Sci. 2016 Nov;121(4):211-215. doi: 10.1080/03009734.2016.1206152. 

Download Article
Received October 13, 2021.
Accepted October 27, 2021.
©2021 International Medical Research and Development Corporation.