scholarly journals Iron+folic acid distribution and consumption through antenatal care: identifying barriers across countries

2015 ◽  
Vol 19 (4) ◽  
pp. 732-742 ◽  
Author(s):  
Celeste Sununtnasuk ◽  
Alexis D’Agostino ◽  
John L Fiedler
Keyword(s):  
Folic Acid ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Policy Makers ◽  
The Past ◽  
Iron Folic Acid ◽  
The Ideal

AbstractObjectiveThe prevalence of maternal anaemia remains unacceptably high in developing countries. At the same time, the percentage of women who consume one or more Fe+folic acid (IFA) tablets during pregnancy remains persistently low. The objective of the present study was to identify where, within antenatal care (ANC) programmes, pregnant women falter in obtaining and consuming an ideal minimum of 180 IFA tablets.DesignData from Demographic and Health Surveys were used to develop a schematic which identifies four sequential ‘falter points’ to consuming 180 IFA tablets: ANC attendance, IFA receipt or purchase, IFA consumption and the number of tablets consumed.SettingTwenty-two countries with high burdens of undernutrition.SubjectsA sample of 162 958 women, 15 to 49 years of age, with a live birth in the past 5 years.ResultsAcross all countries, 83 % of all pregnant women had at least one ANC visit, 81 % of whom received IFA tablets. Of those receiving IFA tablets, 95 % consumed at least one. Overall adherence to the ideal supplementation regimen, however, was extremely low: only 8 % consumed 180 or more IFA tablets. There were only two countries in which the percentage of pregnant women consuming 180 or more tablets exceeded 30 %.ConclusionsWhile most women receive and take some IFA tablets, few receive or take enough. The analysis identifies where ANC-based distribution of IFA falters in each country. It enables policy makers to design and prioritize follow-up activities to more precisely identify barriers, an essential next step to improving IFA distribution through ANC.

scholarly journals The effect of early antenatal booking on adherence to Iron/folic acid supplementation among antenatal care attendees in Libo kemkem district, Ethiopia

2019 ◽  
Author(s):  
Tewachew Muche liyeh ◽  
Yitayal Ayalew Goshu ◽  
Amare Simegn Ayele ◽  
Yibeltal Abebe
Keyword(s):  
Folic Acid ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Folic Acid Supplementation ◽  
Medical Advice ◽  
Adherence Rate ◽  
Acid Supplementation ◽  
Iron And Folic Acid ◽  
Iron Folic Acid Supplementation ◽  
Iron Folic Acid

Abstract Background Iron and folic acid supplementation is the feasible and cost effective strategy to control and prevent anemia in pregnancy. Pregnant women are vulnerable for iron deficiency anemia due to increased nutrient requirement during pregnancy. In Ethiopia, the national data suggests that from all pregnant women supplemented with these tablets, only 5.1% consumed more than 90 tablets during their pregnancy time. The factors for this low adherence are not clearly known. Objective: To assess factors associated with adherence to iron-folic acid supplementation among pregnant women attending antenatal care service in Libo Kemkem district, Ethiopia 2017. Method: Hospital based cross sectional study was conducted using quantitative methods on 406 pregnant women attending antenatal care at Libo Kemkem district public health institutions. Systematic random sampling method was used. An interview with pre tested semi structured questionnaire was carried out. The collected data was entered in Epi data 4.1 and analyzed with SPSS version 20. Bivariate and multivariable logistic regression model were used. Odds ratio with 95% interval was computed and P- value <0.05% considered as level of significance. Result: About 406 respondents were included in the study. The adherence rate of iron-folic acid supplementation was 49.3% (95% CI= 44.3%-54.2%). Factors significantly associated with adherence to iron-folic acid utilization were urban residence (AOR =4.8, 95% CI=1.82-12.79), women aged 21-30 (AOR = 4.3, 95% CI=1.60-11.42) ,women aged 31-40 (AOR =4.2, 95% CI=1.33-13.41),early ANC booking (AOR =4.1, 95% CI=1.80-9.30) and getting medical advice (AOR = 2.5, 95% CI = 1.04 – 6.16). Fear of side effects, forgetfulness and too many pills were the major reasons for missing the doses of tablets. Conclusion: adherence rate of iron and folic acid supplementation was low. Residence, maternal age, early ANC booking and getting medical advice were significantly associated with adherence to iron and folic acid. Key Words: Iron-folic acid, pregnant women and adherence

scholarly journals Socio-demographic and economic determinants of adherence to iron intake among pregnant women in selected low and lower middle income countries in Asia: insights from a cross-country analyses of global demographic and health surveys

2018 ◽  
Vol 5 (4) ◽  
pp. 1552 ◽  
Author(s):  
Kirti Warvadekar ◽  
J. C. Reddy ◽  
Sona Sharma ◽  
Kirk A. Dearden ◽  
Manoj Kumar Raut
Keyword(s):  
Folic Acid ◽  
Antenatal Care ◽  
Health Surveys ◽  
Predictive Analytics ◽  
Haemoglobin Concentration ◽  
Public Health Problem ◽  
The Philippines ◽  
Demographic And Health Surveys ◽  
Iron Intake ◽  
Iron And Folic Acid

Background: Anaemia is a global public health problem affecting around 800 million children and women worldwide. Anaemia, defined as a reduced haemoglobin concentration, is associated with increased peri-natal mortality, increased child morbidity and mortality, impaired mental development, impaired immune competence, increased susceptibility to lead poisoning, and decreased performance at work.Methods: This paper attempts to understand the determinants underlying iron intake in select countries in Asia using multivariate regression analyses of recent data from the Demographic and Health Surveys of eight countries of Afghanistan, Cambodia, India, Indonesia, Myanmar, Nepal, Pakistan, and the Philippines. The individual level data was analysed, using Predictive Analytics Software for Windows (PASW) 18.0 release.Results: After adjusting for standard co-variates, exposure to newspaper was found to be associated with increased adherence to iron tablets or syrup, in five of the eight countries (India, Indonesia, Nepal, Pakistan, and the Philippines). Exposure to television was significantly associated with coverage and adherence to iron tablets or syrup in Afghanistan, India, Indonesia and Myanmar. Those who received at least three antenatal care visits were much more likely to adhere to at least 90 days of iron tablet or syrup or iron and folic acid tablets supplementation.Conclusions: Based on insights from eight demographic and health surveys, mass media (including print and TV), as well as antenatal care-seeking visits seem to be a particularly effective ways of reaching women and in increasing the likelihood of uptake of iron only or iron and folic acid supplements.

scholarly journals Can an Enhanced Iron-Folic Acid Supplementation Program Reduce Neonatal Mortality? Analysis of Pooled Nepal Demographic and Health Surveys

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 823-823
Author(s):  
Michael Dibley ◽  
Yasir Nisar ◽  
Shahreen Raihana ◽  
Patrick Kelly
Keyword(s):  
Folic Acid ◽  
Neonatal Mortality ◽  
Health Surveys ◽  
Neonatal Period ◽  
Cox Proportional Hazards ◽  
Cluster Sampling ◽  
Demographic And Health Surveys ◽  
Risk Of Death ◽  
Iron Folic Acid ◽  
The Impact

Abstract Objectives Nepal has improved the national antenatal iron-folic acid (IFA) supplementation program through the ‘Iron Intensification Project’ (IIP) between 2003 and 2011. This study assesses the effect of this enhanced IFA supplementation on the risk of neonatal mortality over a 20-year period in Nepal. Methods For the impact evaluation, we used a non-randomized stepped wedge study design, using survival information from 16,159 most recent live births from the pooled data from four Nepal Demographic and Health Surveys (2001, 2006, 2011 and 2016). The primary outcomes were neonatal mortality indicators. The use of any antenatal care (ANC) services and antenatal IFA supplements were the secondary outcomes. The main exposure variable was the status of the IIP in the district of the mother's residence at the time of birth. Analyses used multivariate Cox proportional hazards regression, adjusted for up to 22 potential confounders, and the cluster sampling design. Results After the IIP, the risk of death on the first day of life was significantly reduced by 35% [adjusted hazard ratio (aHR) 0.65, 95% confidence interval (95% CI) 0.43 to 0.97], in the early neonatal period by 32% (aHR 0.68, 95% CI 0.48 to 0.96), and in the neonatal period by 29% (aHR 0.71, 95% CI 0.51 to 0.99). After the IIP, there was a significant reduction of the odds of non-use of ANC services and IFA supplements. Conclusions An enhanced IFA supplementation program was associated with a significant reduction in neonatal mortality in Nepal. Funding Sources Ph.D. scholarship from the University of Sydney.

scholarly journals Is Distribution a Problem in Iron-Folic Acid Consumption in India? An Exploration of District Level Household Survey

2020 ◽  
Vol 12 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Shiva S. Halli ◽  
Rajeshwari A. Biradar
Keyword(s):  
Folic Acid ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Household Survey ◽  
District Level ◽  
Indian States ◽  
The Government ◽  
Iron Folic Acid ◽  
Almost All ◽  
Women In India

Aims: Anemia accounts for 40% of maternal deaths in India. In order to address this problem, the Government of India implemented the largest programme with the greatest potential to reduce maternal mortality by free distribution of Iron-Folic Acid (IFA) supplementations especially during Antenatal Care (ANC) visits. But the major concern among the policymakers and researchers has been poor adherence to the supplement among pregnant women. However, we tend to think that given the severity of the problem, there is no investigation on the adherence issue. Hence, the aim of the paper is to understand whether IFA consumption by pregnant women in India is largely a distribution problem of IFA supplements through ANC. Background: The distribution of Iron-Folic Acid (IFA) supplementation is not working especially through Antenatal Care (ANC) attendance. The program implementers believe that it is because of lack of adherence to IFA supplements by pregnant women. It is important to investigate the problem before any policy changes are made without proper evidence. Objectives: The purpose of this study is to examine whether the problem of IFA consumption by pregnant women is due to the problem of public distribution of IFA supplements through ANC attendance. Methods: This study had used the fourth round of District Level Household Survey data, which collects information on IFA supplements, their distribution and consumption. Bivariate and tri-variate analyses were used to understand the relationship between IFA distribution to pregnant women and their consumption patterns in 19 Indian states and two Union Territories (UTs) of pregnant women (88,487) and between the age of 15-49 years. Results: In almost all the states except Chhattisgarh, more than 75% of the pregnant women consumed 100 or more IFA supplements when they received 100 or more IFA supplements from providers. Similar is the case even among those women who received 100 or more IFA supplements through 1 or 2 ANC attendance except Arunachal Pradesh (60%), Meghalaya (67%), Pondicherry (57%) and Andaman and Nicobar (0%). The consumption of IFA supplements among pregnant women gets better than 75% if they receive 100 or more supplements only after attending three or more ANCs. Conclusion: It seems that distribution is a problem in the consumption of IFA supplements by pregnant women in India. Full antenatal attendance by the women could be part of the problem but not supplying at least 100 IFA supplementations to even those who attend ANC due to stock-outs and ineffective management is a serious concern. Hence, Governments should distribute at least the recommended 100 IFA supplements to the women in their 1st ANC attendance to address anaemia.

scholarly journals Adherence to iron with folic acid supplementation and its associated factors among pregnant women attending antenatal care follow up at Debre Tabor General Hospital, Ethiopia, 2017

PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0210086 ◽  
Author(s):  
Alemayehu Digssie Gebremariam ◽  
Sofonyas Abebaw Tiruneh ◽  
Bedilu Abebe Abate ◽  
Melaku Tadege Engidaw ◽  
Desalegn Tesfa Asnakew
Keyword(s):  
Folic Acid ◽  
Antenatal Care ◽  
Pregnant Women ◽  
General Hospital ◽  
Associated Factors ◽  
Folic Acid Supplementation ◽  
Acid Supplementation ◽  
Debre Tabor

scholarly journals Association between adherence to iron intake and anaemia prevalence among women in Cambodia and India: new evidence from recent global demographic and health surveys

2018 ◽  
Vol 5 (7) ◽  
pp. 3061 ◽  
Author(s):  
Manoj Kumar Raut ◽  
J. C. Reddy ◽  
Md. Ataur Rahman
Keyword(s):  
Folic Acid ◽  
Antenatal Care ◽  
Health Surveys ◽  
Predictive Analytics ◽  
Haemoglobin Concentration ◽  
Public Health Problem ◽  
Demographic And Health Surveys ◽  
Care Seeking ◽  
Global Public Health ◽  
Iron And Folic Acid

Background: Anaemia is a global public health problem affecting around 800 million children and women worldwide. Anaemia, defined as a reduced haemoglobin concentration, is associated with increased peri-natal mortality, increased child morbidity and mortality, impaired mental development, impaired immune competence, increased susceptibility to lead poisoning, and decreased performance at work.Methods: This paper attempts to understand the determinants underlying iron and folic acid intake and correlates of anaemia prevalence in two countries in the Asia region using multivariate binary logistic regression analyses of recent data from the Demographic and Health Surveys of Cambodia and India. The individual level data was analysed, using Predictive Analytics Software for Windows (PASW) 18.0 release.Results: After adjusting for standard co-variates, reading newspaper and watching television was significantly associated with coverage, while reading newspaper and listening to radio was significantly associated with adherence to iron tablets or syrup in India. In case of both Cambodia and India, those who received at least three antenatal care visits were much more likely to adhere to at least 90 days of iron tablet or syrup or iron and folic acid tablets, more so in Cambodia compared to India. Those who reported to have adhered to at least 90 days of iron and folic acid tablets in India were more likely to be not anaemic unlike in case of Cambodia.Conclusions: Antenatal care-seeking visits seem to be a particularly effective ways of reaching women and in increasing the likelihood of intake of iron only or iron and folic acid supplements.

scholarly journals Adherence to prenatal iron–folic acid supplementation and associated factors among pregnant women attending antenatal care services in Dilla town, South Ethiopia

2021 ◽  
Vol 5 ◽  
pp. 239920262110088
Author(s):  
Tizalegn Tesfaye Mamo ◽  
Eden Ashenafi ◽  
Addisu Alemayehu Gube ◽  
Tesfanew Bekele
Keyword(s):  
Public Health ◽  
Folic Acid ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Associated Factors ◽  
Folic Acid Supplementation ◽  
Care Services ◽  
History Of ◽  
Iron Folic Acid Supplementation ◽  
Iron Folic Acid

Background: During pregnancy, due to the physiological and hormonal change, the requirement of iron–folic acid is enhanced. Therefore, the occurrence of iron/folic acid deficiency is relatively high and it is responsible for 95% of anemia during pregnancy. Objectives: The aim of this study was to assess adherence to prenatal iron–folic acid supplementation (IFAS) and associated factors among pregnant women attending antenatal care services at public health facilities of Dilla town. Methods: Facility-based cross-sectional study design was employed selecting 403 pregnant women attending antenatal care services in three public health institutions of Dilla town. The women were included in the study by simple random sampling. Data were collected by interview and document review. Then it was entered into EPI Data version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression techniques were used to identify independent predictors. A p-value <0.05 was taken as indication of statistical significance. Results: From the total of planned 403 pregnant women, 396 participated in the study, with a response rate of 98.2%. Of these, 172 (43.4%) pregnant women were adhered to IFAS. The study also revealed that history of previous anemia (adjusted odds ratio (AOR) = 1.87; 95% confidence interval (CI): (1.01–3.47); p = 0.04), frequency of antenatal care center (ANC) visits (AOR = 2.51; 95% CI: (1.17–5.37); p = 0.01), knowledge of IFA supplement (AOR = 2.28; 95% CI: (1.36–3.82); p = 0.002), and knowledge of anemia (AOR = 2.30; 95% CI: (1.40–3.77); p = 0.001) were independent predictors of adherence to IFAS. Conclusion: The finding of this study showed that less than half of the pregnant women were adhered to IFAS. History of previous anemia, frequency of ANC visits, knowledge of IFA supplement, and knowledge of anemia were the factors associated with adherence to IFA supplement.

Sign in / Sign up

Export Citation Format

Share Document