title: Healthcare providers' views on the delivery of preconception care in a local community setting in the Netherlands.
abstract: The attention for preconception care (PCC) has grown substantially in recent years, yet PCC is far from routine in daily practice. One of the major challenges for the implementation of PCC is to identify how it can best be organized and provided within the primary care setting. The aim of this study was to identify bottlenecks and solutions for the delivery of PCC from a healthcare providers' perspective in a local community setting in the Netherlands.
  
  
  
  Health professionals within the region of Zeist, the Netherlands, were invited for a meeting on the local implementation of PCC. Five parallel group sessions were held with 30 participants from different disciplines. The sessions were moderated based on the Nominal Group Technique, in which bottlenecks (step 1) and solutions (step 2) for the delivery of PCC were gathered, categorized and prioritized by the participants.
  
  
  
  Participants expressed that the provision of PCC is challenging due to lack of awareness, the absence of a costing structure and unclear allocation of responsibilities. The most pragmatic approach considered was to make interdisciplinary arrangements within the local primary care setting. Participants recommended to 1) settle a costing structure by means of third party reimbursement, 2) improve collaboration by means of a local cooperation network and an adequate referral system, 3) invest in education, tools and logistics and 4) increase uptake rates by the routine opportunistic offer of PCC and promotional campaigns.
  
  
  
  From a provider's perspective a tailored approach is advocated in which interdisciplinary arrangements for collaboration and referral are set up within the local primary care setting.
authors.affiliation: Division Woman and Baby, University Medical Center Utrecht, P.O. Box 85090, Utrecht, 3508 AB, The Netherlands. m.poels@umcutrecht.nl.
authors.forename: M
authors.initials: M
authors.lastname: Poels
authors.affiliation: Division Woman and Baby, University Medical Center Utrecht, P.O. Box 85090, Utrecht, 3508 AB, The Netherlands.|Present Address: Department of Obstetrics and Gynecology, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands.
authors.forename: M P H
authors.initials: MP
authors.lastname: Koster
authors.affiliation: Division Woman and Baby, University Medical Center Utrecht, P.O. Box 85090, Utrecht, 3508 AB, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Franx
authors.affiliation: Department of Health Technology Assessment, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, Utrecht, 3508 GA, The Netherlands.
authors.forename: H F
authors.initials: HF
authors.lastname: van Stel
mesh_terms: D001291:Attitude of Health Personnel; D003153:Community Health Services; D003299:Cooperative Behavior; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D009426:Netherlands; D016742:Preconception Care; D011247:Pregnancy; D011320:Primary Health Care
keywords: Healthcare delivery; Healthcare providers; Implementation strategy; Preconception care; Qualitative research