Preconception care as a public health strategy: A comparative analysis of international frameworks and the healthcare system in Kazakhstan
DOI:
https://doi.org/10.37800/RM.2.2026.766Keywords:
preconception care, preconception health, reproductive health, primary health care, health systems, public health policy, maternal healthAbstract
Relevance: Preconception care (PCC) is increasingly recognized as a critical component of preventive medicine and reproductive health systems, aimed at improving maternal and perinatal outcomes. Despite growing international attention, the implementation and organization of PCC vary significantly across countries.
This study aimed to analyze the organization of preconception care for women of reproductive age in the Republic of Kazakhstan and compare it with contemporary international models to identify key gaps and priority areas for system improvement.
Methods: A narrative review with elements of comparative policy analysis was conducted. The analysis was based on peer-reviewed publications indexed in PubMed, Scopus, and Web of Science, as well as international guidelines and national regulatory documents related to preconception care. Publications from 2015 to 2025 were prioritized. A comparative analytical framework was applied to assess key dimensions, including institutionalization, regulatory environment, target population, integration into primary health care, scope of interventions, digitalization, and multidisciplinary involvement.
Results: The findings indicate that preconception care has evolved from a narrowly defined clinical intervention into a comprehensive public health strategy grounded in a life-course approach. International models are characterized by broader population coverage, multidisciplinary integration, and increasing use of digital tools. In Kazakhstan, PCC is highly institutionalized and integrated into primary health care; however, it remains primarily focused on women planning pregnancy and is largely biomedical in orientation. Key gaps include limited population-level coverage, insufficient integration of psychosocial determinants, and underdeveloped digital infrastructure.
Conclusions: While Kazakhstan has established a strong regulatory framework for preconception care, further development is required to align with international best practices. Expanding target populations, strengthening multidisciplinary and intersectoral approaches, and implementing digital health solutions are essential for improving the effectiveness and sustainability of PCC.
References
1. Stephenson J, Heslehurst N, Hall J, Schoenaker DAJM, Hutchinson J, Cade JE, Poston L, Barrett G, Crozier SR, Barker M, Kumaran K, Yajnik CS, Baird J, Mishra GD. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. Lancet. 2018 May 5;391(10132):1830-1841.
https://doi.org/10.1016/S0140-6736(18)30311-8
Erratum in: Lancet. 2018 May 5;391(10132):1774.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30979-6/fulltext
2. WHO Policy Brief. Preconception care: Maximizing the gains for maternal and child health – Policy brief [Internet]. www.who.int. Available from:
https://www.who.int/publications/i/item/WHO-FWC-MCA-13.02:1–8.
3. Chingara O, Sümegi A, Logan S, Bhattacharya S, Woolner A. What do we mean by preconception health and preconception care in research and policy? A systematic review. Hum Reprod Update. 2026 Mar 5: dmag005.
https://doi.org/10.1093/humupd/dmag005
4. Black KI, Dorney E. Recent advances in preconception care. Curr Opin Obstet Gynecol. 2025 Oct 1;37(5):303-310.
https://doi.org/10.1097/gco.0000000000001060
5. Benedetto C, Borella F, Divakar H, O’Riordan SL, Mazzoli M, Hanson M, O’Reilly S, Jacobsson B, Conry JA, McAuliffe FM; FIGO Committee on Well Woman Healthcare, FIGO Committee on the Impact of Pregnancy on Long-Term Health. FIGO Preconception Checklist: Preconception care for mother and baby. Int J Gynaecol Obstet. 2024 Apr;165(1):1-8.
https://doi.org/10.1002/ijgo.15446
6. Ojeda LI, Valencia CM, Cardozo Buitrago N, Anumba D, Gudu W, Bianchi A, Jacobsson B; FIGO Committee for Preterm Birth. FIGO good practice recommendations on preconception care: A strategy to prevent preterm birth. Int J Gynaecol Obstet. 2025 Nov;171(2):574-587.
https://doi.org/10.1002/ijgo.70495
7. Liu S, Augustin G, Ning N, Ota E. Preconception educational interventions for women, present landscape, gaps, and future directions: A scoping review. Int J Nurs Stud. 2025 Sep;169:105134.
https://doi.org/10.1016/j.ijnurstu.2025.105134
8. Aynalem YA, Paul P, Kung JY, Hussain A, Lassi Z, Meherali S. Understanding preconception care: a scoping review of knowledge, attitudes and practices among reproductive age individuals, healthcare workers and stakeholders in low- and middle-income countries. BMJ Open. 2025 Jun 27;15(6):e099143.
https://doi.org/10.1136/bmjopen-2025-099143
9. Khekade H, Potdukhe A, Taksande AB, Wanjari MB, Yelne S. Preconception Care: A Strategic Intervention for the Prevention of Neonatal and Birth Disorders. Cureus. 2023 Jun 29;15(6):e41141.
https://doi.org/10.7759/cureus.41141
10. Bischoff M, Howland V, Klinger-König J, Tomczyk S, Schmidt S, Zygmunt M, Heckmann M, van den Berg N, Bethke B, Corleis J, Günther S, Liutkus K, Stentzel U, Neumann A, Penndorf P, Ludwig T, Hammer E, Winter T, Grabe HJ. Save the children by treating their mothers (PriVileG-M-study) - study protocol: a sequentially randomized controlled trial of individualized psychotherapy and telemedicine to reduce mental stress in pregnant women and young mothers and to improve Child’s health. BMC Psychiatry. 2019 Nov 27;19(1):371.
https://doi.org/10.1186/s12888-019-2279-0
11. Giouleka S, Papagera V, Siargkas A, Michos G, Liberis A, Kalogiannidis I, Mamopoulos A, Tsakiridis I, Dagklis T. Preconception Care: A Comparative Review of Major Guidelines. Obstet Gynecol Surv. 2025 Aug;80(8):491-505.
https://doi.org/10.1097/ogx.0000000000001425
12. Xu J, Li X, Zhou Q. Nationwide-free preconception care strategy: Experience from China. Front Public Health. 2022 Oct 19; 10:934983.
https://doi.org/10.3389/fpubh.2022.934983
13. Schoenaker D, Lovegrove EM, Cassinelli EH, Hall J, McGranahan M, McGowan L, Carr H, Alwan NA, Stephenson J, Godfrey KM. Preconception indicators and associations with health outcomes reported in UK routine primary care data: a systematic review. Br J Gen Pract. 2025 Jan 30;75(751):e129-e136.
https://doi.org/10.3399/bjgp.2024.0082
14. 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.
https://doi.org/10.1093/fampra/cmw094
15. Caut C, Schoenaker D, McIntyre E, Steel A. Health professionals’ beliefs and attitudes towards preconception care: a systematic review. BMC Health Serv Res. 2025 Aug 4;25(1):1023.
https://doi.org/10.1186/s12913-025-13246-y
16. Genuis SJ, Genuis RA. Preconception Care: A New Standard of Care within Maternal Health Services. Biomed Res Int. 2016; 2016:6150976.
https://doi.org/10.1155/2016/6150976
17. Eddelbuettel JCP, Daw JR, Galbraith AA, Gordon SH, Kaimal A, Garabedian LF. New York’s Basic Health Program Increased Subsidized Insurance Coverage From Preconception To The Postpartum Period. Health Aff (Millwood). 2025 Dec;44(12):1497-1504.
https://doi.org/10.1377/hlthaff.2025.00773
18. Padhani ZA, Tessema GA, Avery JC, Rahim KA, Boyle JA, Meherali S, Salam RA, Lassi ZS. Preconception Care Interventions for Adolescents and Young Adults to Prevent Adverse Maternal and Child Health Outcomes: Protocol for an Evidence Gap Map. JMIR Res Protoc. 2024 May 24;13:e56052.
19. Maas VYF, Poels M, Ista E, Menge LF, Vanden Auweele KLHE, de Bie RWA, de Smit DJ, van Vliet-Lachotzki EH, Franx A, Koster MPH. The effect of a locally tailored intervention on the uptake of preconception care in the Netherlands: a stepped-wedge cluster randomized trial (APROPOS-II study). BMC Public Health. 2022 Nov 1;22(1):1997.
https://doi.org/10.1186/s12889-022-14343-x
20. Musgrave L, Cheney K, Dorney E, Homer CSE, Gordon A. Addressing Preconception Behavior Change Through Mobile Phone Apps: Systematic Review and Meta-analysis. J Med Internet Res. 2023 Apr 19;25: e41900.
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