Uncovering barriers to preconception care: perspectives of healthcare professionals through a Q methodology study
4 affiliations
- 1Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- 2Department of Vice Chancellor for Health Affairs, Population, Family and School Health Group, Kurdistan University of Medical Sciences, Sanandaj, Iran
- 3Health Network of Sanandaj, Kurdistan University of Medical Sciences, Sanandaj, Iran
- 4Department of Ear, Nose and Throat, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
Abstract
Background: Despite the established benefits of preconception care for both mothers and babies, its widespread provision faces significant challenges. Preconception care encompasses a range of interventions aimed at optimizing a woman’s health before pregnancy. This can significantly improve pregnancy outcomes and the health of the child. However, various obstacles hinder the effective delivery of preconception care services. This study sought to identify these barriers from the perspective of healthcare professionals, specifically midwives and OBGYNs.
Method: To understand the challenges to preconception care from the perspective of healthcare professionals directly involved in women’s health, this study interviewed 34 health professionals, including 29 midwives and 5 obstetrics and gynecology specialists (OB-GYNs). The participants were purposefully selected from a range of public health centers and hospitals to capture diverse professional experiences. A total of 48 potential barriers to preconception care were initially identified through arrative literature review, gray literature and semi-structured interviews with midwives and OB-GYNs. These barriers were then rated by participants on an 11-point Likert scale ranging from − 5 (strongly disagree) to + 5 (strongly agree). The data were analyzed with PQMethod 2.35 software to identify key themes and shared viewpoints.
Findings: The analysis revealed five clusters of barriers perceived by midwives. These included: Access and affordability (18%), Provider-related issues (11%), Sociocultural and organizational factors (8%), Lack of awareness and prioritization (7%), and Structural and socioeconomic inequities (6%).
Conclusion: This study offers valuable insights into the multifaceted nature of barriers to preconception care. By identifying these key challenges from the perspective of midwives, this research can inform the development of targeted interventions to improve access to and quality of preconception care services.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-15295-3.
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BibTeX
@article{mahmoodi2026uncovering,
title = {{Uncovering barriers to preconception care: perspectives of healthcare professionals through a Q methodology study}},
author = {Hassan Mahmoodi and Mehdi Zukaie and Rosita Yasmanpour and Pershang Sharifi Saqezi},
journal = {BMC Health Services Research},
year = {2026},
month = aug,
doi = {10.1186/s12913-026-15295-3},
url = {https://doi.org/10.1186/s12913-026-15295-3},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Uncovering barriers to preconception care: perspectives of healthcare professionals through a Q methodology study
AU - Hassan Mahmoodi
AU - Mehdi Zukaie
AU - Rosita Yasmanpour
AU - Pershang Sharifi Saqezi
PY - 2026
DA - 2026/08/06
JO - BMC Health Services Research
DO - 10.1186/s12913-026-15295-3
UR - https://doi.org/10.1186/s12913-026-15295-3
AB - Background: Despite the established benefits of preconception care for both mothers and babies, its widespread provision faces significant challenges. Preconception care encompasses a range of interventions aimed at optimizing a woman’s health before pregnancy. This can significantly improve pregnancy outcomes and the health of the child. However, various obstacles hinder the effective delivery of preconception care services. This study sought to identify these barriers from the perspective of healthcare professionals, specifically midwives and OBGYNs. Method: To understand the challenges to preconception care from the perspective of healthcare professionals directly involved in women’s health, this study interviewed 34 health professionals, including 29 midwives and 5 obstetrics and gynecology specialists (OB-GYNs). The participants were purposefully selected from a range of public health centers and hospitals to capture diverse professional experiences. A total of 48 potential barriers to preconception care were initially identified through arrative literature review, gray literature and semi-structured interviews with midwives and OB-GYNs. These barriers were then rated by participants on an 11-point Likert scale ranging from − 5 (strongly disagree) to + 5 (strongly agree). The data were analyzed with PQMethod 2.35 software to identify key themes and shared viewpoints. Findings: The analysis revealed five clusters of barriers perceived by midwives. These included: Access and affordability (18%), Provider-related issues (11%), Sociocultural and organizational factors (8%), Lack of awareness and prioritization (7%), and Structural and socioeconomic inequities (6%). Conclusion: This study offers valuable insights into the multifaceted nature of barriers to preconception care. By identifying these key challenges from the perspective of midwives, this research can inform the development of targeted interventions to improve access to and quality of preconception care services. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-15295-3.
SN - 1472-6963
ER -