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Introduction: The World Health Organization has suggested preconception care to improve pregnancy outcomes. Hence, the study aimed to compare the effect of preconception care on pregnancy outcomes, particularly prematurity and low birth weight. Methods: We carried out interventions in one tribal and one non-tribal block. For comparison, one adjacent tribal block and one non-tribal block were included in Nashik district, India. The total study period was from April 2018 to July 2021. All reproductive age group women desiring pregnancy within one year in selected four blocks participated in the study. The services included clinical examination, laboratory investigations, treatment, six-monthly deworming, anemia management, folic acid supplementation, family planning services, and behavioral change communication using different media. The existing healthcare workers provided services to the women until they became pregnant or until the end of the follow-up period (27 months). We monitored pregnancy outcomes, including abortion, stillbirth, and live birth; among live births, low birth weight, preterm birth, congenital physical anomaly, and neonatal death. Results: The study enrolled 7,875 women, and 3,601 had outcomes. The proportion of preterm births in the intervention and comparison block was 11.18 % and 14.99 %, respectively (p = 0.001), and the proportion of low-birth-weight babies was 9.23 % and 11.25 %, respectively (p = 0.01). The adjusted prevalence ratio showed that the risk of preterm births in the absence of intervention was 1.3 (CI: 1.1–1.6). Preterm birth was a mediator between preconception care and low birth weight. Conclusion: Reduction in proportion of low birth weight and preterm babies can be achieved through preconception care using minimal additional resources.

Background: Family planning services have been given importance for decades. For various reasons, sterilization has been the first choice of women and the government. It is feared that while achieving large numbers, the quality may be compromised. There were Public Interest Litigations in Supreme Court about the compromised quality of sterilization services. Objectives: The aim of this study was to compare the quality of sterilization services before and after interventions and the quality between types of institutions. Materials and Methods: This study was carried out in two phases. The first phase included visits to 33 institutions from 13 districts on sterilization operation days. The observed lacunae were communicated to the government, and accordingly, some interventions were executed by the government. In the second phase, we visited 13 institutions from five districts. The investigators were from the Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, India. We used assessment tools based on the Government of India’s guidelines. One device was developed to assess the quality of services, and marks were given by dichotomizing the observations. In both phases, the same tool was used. The maximum score was 140. Results: In the first phase, an institution’s mean score was 94.15 (±7.58). There was no difference between the types of institutions. In the second phase, the mean score improved to 103.27 (±13.29) (t = 2.94; P = 0.01); the hospital score improved from 91.00 to 109.83 (t = 4.94; P = 0.001). Conclusion: The findings of this unique multisite study indicate that interventions indeed led to improvements in both primary health centers and hospitals, but the extent of improvement was more significant in hospitals.