title: Preconception health promotion: analysis of means and constraints.
abstract: OBJECTIVE
  To assess means and constraints of preconception care implementation.
  
  
  METHODS
  Three strategies were applied to promote preconception health: organisation of a campaign, production of guidelines, and implementation of a preconception pilot clinic. Three surveys investigated the knowledge and practices of women before and after the campaign, and one survey assessed the attitudes of gynaecologists.
  
  
  RESULTS
  Posters and leaflets are more efficient than TV spots; implementation of a pilot clinic enhances all activities in the field of preconception health. With regard to constraints, we observed that (i) preconception care could not be provided when pregnancy was unplanned; (ii) the necessity of postponing pregnancy interfered with vaccinations; (iii) the compliance of women with regard to the prolonged intake of folates is poor; (iv) the application of guidelines by providers is inconsistent; (v) providers lack training regarding genetic ethical stakes; and (vi) practitioners find it difficult to integrate the concept of private eugenics and to envision the probabilistic character of the clinical manifestations of inherited diseases.
  
  
  CONCLUSIONS
  We propose (i) flour fortification with folic acid; (ii) timely immunisation by preventive medicine at school, and (iii) continuous training of health care providers in the provision of preconception care.
authors.affiliation: Office de la Naissance et de l'Enfance (ONE), Brussels, Belgium. pierre.delvoye@ulb.ac.be
authors.forename: Pierre
authors.initials: P
authors.lastname: Delvoye
authors.forename: Caty
authors.initials: C
authors.lastname: Guillaume
authors.forename: Sarah
authors.initials: S
authors.lastname: Collard
authors.forename: Tonia
authors.initials: T
authors.lastname: Nardella
authors.forename: Valérie
authors.initials: V
authors.lastname: Hannecart
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Mauroy
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001530:Belgium; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D016742:Preconception Care / Q000458:organization & administration*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011295:Prenatal Care / Q000458:organization & administration; D016387:Women's Health; D055815:Young Adult