Review Article

Preventing Early Pregnancy and Pregnancy-Related Mortality and Morbidity in Adolescents in Developing Countries: The Place of Interventions in the Prepregnancy Period

Table 1

See [14].

Illustrated examples of preconception care interventions

Nutritional conditionsSupply iron and folic acid
Screen for anaemia
Monitor nutritional status
Provide nutrition education, and counselling

Vaccine-preventable diseasesVaccinate against rubella, tetanus, and hepatitis B

Genetic conditionsProvide genetic screening, counselling and testing where needed
Discuss reproductive outcomes and options and provide the appropriate services

Environmental healthProvide guidance on how to avoid unnecessary exposure to radiation, pesticides and lead
Promote the use of improved stoves and cleaner liquid/gaseous fuels

Infertility/subfertilityIncrease awareness and understanding on infertility and sub-fertility
Screen, diagnose and treat for infertility and sub-fertility

Female Genital Mutilation (FGM)Increase awareness and understanding on female genital mutilation
Screen to detect complications and provide information on where to get treatment
Carry out defibulation of infibulated or sealed girls and women
Treat complications

Too-early, unwanted, and rapid successive pregnanciesEducate girls and boys about sexuality
Provide contraceptive information and services
Link health service provision to activities aimed at:
(i) reducing marriage before the age of 18 years;
(ii) keeping girls in school

Sexually transmitted infectionsProvide age-appropriate sexual health education and safer sex promotion
Promote condoms
Screen and treat for sexually transmitted infections

HIVProvide age-appropriate sexual health education and safer sex promotion
Provide HIV counselling and testing
Provide treatment for HIV-related illnesses when needed
Enrol women in mother to-child transmission (PMTCT) programmes, antenatal care programmes and provide family planning services

Interpersonal violenceRecognize signs of violence against women
Provide medical and psychosocial care
Link health service provision to activities aimed at:
(i) changing harmful gender norms;
(ii) bringing about gender equality;
(iii) empowering girls and women economically

Mental healthProvide information and counselling
Diagnose and manage mental health and neurological conditions
Link health service provision to activities aimed at strengthening community networks and women’s empowerment

Psychoactive substance abuseScreen for and—where needed—treat substance abuse
Provide information and counselling to reduce substance use

Tobacco useScreen for tobacco use (smoking and smokeless tobacco)
Provide information and counselling on tobacco cessation
Provide information on the dangers of second-hand smoke