Background:
There is a clear link between high quality preconception health and reduction of maternal and neonatal mortality and morbidity. However, preconception health is not yet a priority for most countries. This presentation is an overview of challenges and opportunities for provision of high quality preconception care in developing countries.

Objectives:
Identify those challenges to provision of preconception health care in developing countries which can be met by sharing best practices developed in the U.S.; 2) Identify opportunities within developing countries for improving preconception care that may be applicable to the U.S.

Methods:
Results and conclusions are based on a symposium held at the Third International Conference on Birth Defects and Disabilities in the Developing World, held in June 2007. Papers and discussion identified common challenges, opportunities and what is needed to move forward in improving preconception health care in developing countries.

Results:
Participants identified seven factors that effect implementation of preconception health interventions in developing countries: 1) The need for WHO leadership; 2) Access and quality issues resulting from weak health systems 3) Lack of a model preconception care program that is cost-effective; 4) The need to include men's health in preconception care; 5) The important role that must be played by local health care workers, educators and community leaders; 6) The opportunity to work with local NGOs; 7) The need to focus on the family unit for health education.

Conclusion and implications for practice:
Lessons learned from an examination of both the developed and developing country contexts for improving preconception care can be mutually beneficial. Developed country leadership is needed to achieve agreement on a standard package of interventions and to carry out research on cost-effectiveness of these interventions. This information can be used to influence policymakers at the international level to support preconception care initiatives. Initiatives in developing countries that focus not only on women of childbearing age, but also on men, couples and families, and that involve local leaders and NGOs, may provide valuable lessons for outreach within the U.S.