Primary care providers' perspectives on barriers and enablers influencing preconception care provision for African migrant and refugee women: qualitative interviews.

Preconception care (PCC) is an important preventive strategy for improving maternal and child health, yet its routine delivery in primary care remains inconsistent, particularly for populations experiencing inequities. We explored primary care providers' perspectives on barriers to and enablers of providing PCC to African migrant and refugee women in Victoria, Australia. Eleven primary care providers (four general practitioners, four practice or refugee health nurses, and three maternal and child health nurses) participated in semi-structured interviews. Interviews were transcribed verbatim, de-identified, and analysed using a hybrid deductive-inductive thematic approach guided by the Theoretical Domains Framework, with subthemes mapped to the Capability, Opportunity, Motivation-Behaviour (COM-B) domains. Providers described PCC as important, yet acknowledged that its delivery was inconsistent and often embedded within other consultations rather than delivered in a standalone consultation. Enablers included preventive intent, clinical and communication skills, teamwork, continuity of care, trusted relationships, and the staged use of routine visits to introduce PCC over time. Barriers included limited time, funding and clinic resources, gaps in PCC training, inconsistent interpreter access, and broader social and structural factors influencing women's engagement with care. Improving equitable PCC delivery for African migrant and refugee women will require strategies that strengthen provider capability and address organizational, relational, and system-level conditions that support routine, culturally responsive PCC in primary care.