{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:45:55Z","timestamp":1785735955163,"version":"3.56.0"},"reference-count":17,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["Indian J Med Res"],"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Preconception care (PCC) comprises a set of biomedical, behavioural, and social interventions provided before conception to improve maternal and neonatal outcomes. PCC remains a critical missing link in the continuum of reproductive healthcare in India. This study assessed public health-system preparedness and community perception related to PCC service delivery in Maharashtra.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A mixed-method, pre-intervention situational analysis was conducted to assess public health-system preparedness and community perceptions regarding PCC service delivery in selected districts of Maharashtra, India. Using stratified purposive sampling, 31 public health facilities were assessed using a facility checklist adapted from World Health Organization (WHO) SARA (Service Availability and Readiness Assessment) domains and mapped to WHO health system building blocks. Additionally, 143 key informant interviews (KIIs) were conducted among healthcare providers, and 20 focus group discussions (FGDs) were conducted with newly married couples and mothers-in-law across rural (tribal and non-tribal) and urban (slum and non-slum) settings. Qualitative findings were thematically analysed using the social ecological model. Both models were triangulated using a COM-B (capacity, opportunity, motivation\u2192 behaviour) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All assessed facilities had basic infrastructure and manpower; however, PCC services were largely restricted to anaemia prophylaxis and family planning commodities. Major systemic challenges included the absence of PCC-specific guidelines, irregular supply of essential medicines and diagnostics, limited health management and information systems (HMIS) integration, weak policy coordination, inadequate human resources, and referral pathways. From the community perspective, PCC awareness was negligible; misconceptions linked it to infertility care, and family gatekeeping limited women\u2019s autonomy. Gender norms and poor male involvement further constrained service uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation and conclusions<\/jats:title>\n                    <jats:p>\n                      Although Maharashtra has favourable policy support for PCC through the Mission\n                      <jats:italic>Vatsalya<\/jats:italic>\n                      initiative, significant gaps persist in the health system\u2019s readiness and community awareness. Developing PCC-specific operational and technical guidelines, capacity building, provision of information, and education material, PCC indicator integration in HMIS, and demand generation, coupled with male involvement, can optimise PCC uptake and improve PCC service utilisation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/ijmr_3421_2025","type":"journal-article","created":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T19:47:22Z","timestamp":1785700042000},"page":"260-271","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Public healthcare system preparedness and community perceptions on comprehensive preconception care service delivery in Maharashtra, India"],"prefix":"10.25259","volume":"164","author":[{"given":"Saniya Shafi","family":"Qureshi","sequence":"first","affiliation":[{"name":"Department of Operational and Implementation Research, ICMR-National Institute for Research on Women\u2019s Health (Erstwhile ICMR-NIRRCH), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purvi","family":"Fulmali","sequence":"additional","affiliation":[{"name":"Department of Operational and Implementation Research, ICMR-National Institute for Research on Women\u2019s Health (Erstwhile ICMR-NIRRCH), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavya","family":"M.","sequence":"additional","affiliation":[{"name":"Department of Operational and Implementation Research, ICMR-National Institute for Research on Women\u2019s Health (Erstwhile ICMR-NIRRCH), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragini","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Operational and Implementation Research, ICMR-National Institute for Research on Women\u2019s Health (Erstwhile ICMR-NIRRCH), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailesh","family":"Pande","sequence":"additional","affiliation":[{"name":"Department of Genetic Research Centre, ICMR-National Institute for Research on Women\u2019s Health (Erstwhile ICMR-NIRRCH), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepti","family":"Tandon","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, ICMR-National Institute for Research on Women\u2019s Health (Erstwhile ICMR-NIRRCH), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravleen Kaur","family":"Bakshi","sequence":"additional","affiliation":[{"name":"Division of Descriptive Research, Indian Council of Medical Research, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beena","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Operational and Implementation 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