Understanding Healthcare Workers Perceptions of Iron and Folic Acid Supplementation in Bihar, India

<p>Iron and folic acid supplementation is the key approach for anemia prevention and control during pregnancy. In Ethiopia only <1% of pregnant mothers ingest the ideal number of tablets. Although, adherence is the most important challenge, literature is dearth and the predictors are undoubtedly recognized. Institution based quantitative cross sectional study design triangulated with qualitative methods was employed among 395 systematically selected pregnant mothers attending antenatal care in Debre Markos town, Ethiopia. Data were collected using interviewer administered structured questionnaire. Data were entered into Epi data and exported to SPSS software. Bivariate and multivariable Logistic regression with the 95% confidence interval was computed. P-value < 0.05 was declared as statistically significant. Eight in-depth interviews were conducted. The data were entered and analyzed using open code software. Adherence rate was 55.5% (95%CI, 50.5%-60.4%). Pregnant mothers who had; history of anemia during current pregnancy [AOR:7.9, 95%CI (4.44-14.01)], primary education (AOR:4.0, 95%CI (1.88-8.54)], secondary education and above (AOR:3.6, 95%CI (1.20-6.94)], good knowledge of iron and folic acid supplementation [AOR:2.1, 95%CI (1.24-3.56)], and early registration for antenatal care (AOR:1.8, 95%CI (1.06-3.11)] were predictors of iron and folic acid supplementation adherence. The rate of adherence was low. Getting medical advice and fear of illness if missed were the primary reasons that enforce mothers to take the tablets. Hence, improving mothers’ knowledge regarding overall aspects of the tablet through better advice, community teaching and the mass media at large, would improve adherence.</p>

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Implementation fidelity of nutritional counselling, Iron and Folic Acid supplementation guidelines and associated challenges in rural Uasin Gishu County Kenya

10.21203/rs.3.rs-19945/v5 ◽

2020 ◽

Author(s):

Roselyter Monchari Riang'a ◽

Anne Kisaka Nangulu ◽

Jacqueline E.W. Broerse

Keyword(s):

Folic Acid ◽

Side Effects ◽

Implementation Fidelity ◽

Folic Acid Supplementation ◽

Food Sources ◽

Careful Examination ◽

Acid Supplementation ◽

Nutritional Counselling ◽

Participant Responsiveness ◽

Iron And Folic Acid

Abstract BackgroundImplementation fidelity which is defined as the degree to which programmes are implemented as intended is one of the factors that affect programme outcome, thus requiring careful examination. This study aims to acquire insight into the degree to which nutritional counselling and Iron and Folic Acid supplementation (IFAs) policy guidelines during pregnancy have been implemented as intended and the challenges to implementation fidelity.MethodsData were collected in rural Uasin Gishu County in the western part of Kenya through document analysis, questionnaires among intervention recipients (n=188) and semi-structured interviews with programme implementers (n=6). Data collection and analysis were guided by an implementation fidelity framework. We specifically evaluated adherence to intervention design (content, frequency, duration and coverage), exposure or dosage, quality of delivery and participant responsiveness.ResultsCoverage of nutritional counselling and IFAs policy is widespread. However, partial provision was reported in all the intervention components. Only 10% accessed intervention within the first trimester as recommended by policy guidelines, only 28% reported receiving nutritional counselling, only 18% and 15% of the respondents received 90 or more iron and folic acid pills respectively during their entire pregnancy period, and 66% completed taking the IFAs pills that were issued to them. Late initial bookings to antenatal care, drug stock shortage, staff shortage and long queues, confusing dosage instructions, side effects of the pills and issuing of many pills at one go, were established to be the main challenges to effective implementation fidelity. Anticipated health consequences and emphasis by the health officer to comply with instructions were established to be motivations for adherence to nutritional counselling and IFAs guidelines.ConclusionsImplementation fidelity of nutritional counselling and IFAs policy in Kenya is generally weak. There is need for approaches to enhance early access to interventions, enhance stock availability, provide mitigation measures for the side effects, as well as intensify nutritional counselling to promote the consumption of micronutrient-rich food sources available in the local environment to substitute for the shortage of nutritional supplements and low compliance to IFAs.

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Compliance with Iron and Folic Acid Supplementation (IFAS) and associated factors among pregnant women in Sub-Saharan Africa: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0249789 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249789

Author(s):

Meseret Belete Fite ◽

Kedir Teji Roba ◽

Lemessa Oljira ◽

Abera Kenay Tura ◽

Tesfaye Assebe Yadeta

Keyword(s):

Systematic Review ◽

Folic Acid ◽

Pregnant Women ◽

Meta Analysis ◽

Folic Acid Supplementation ◽

Sub Saharan Africa ◽

Global Public Health ◽

Acid Supplementation ◽

Iron And Folic Acid ◽

Sub Saharan

Background Anemia is one of the world’s leading cause of disability and the most serious global public health issues. This systematic review and meta-analysis was conducted very carefully in order to give up the pooled compliance of Iron and Folic-Acid Supplementation in Sub-Saharan Africa. Methods To conduct this brief systematic review and meta-analysis, a related literature search was done from different sources, PubMed Medline and Google Scholar Journals. Then IFA Supplementation related searching engine was used to make the work more meaningful and intensive. Moreover, we used modified Newcastle-Ottawa quality assessment scale for cross sectional studies to assess the quality of the study in terms of their inclusion. Then, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to carry out the work in a carful manner. Finally, the pooled effect size was computed using the review manager and Compressive Meta-analysis software. Results Twenty-three studies, which encompassed 24272 pregnant women, were chosen for the analysis. From those an overall prevalence of compliance with Iron and Folic Acid Supplementation (IFAS) in pregnancy in SSA was 39.2%. However, the result from meta-analysis showed that women who were counseled on IFAS in their courses of pregnancy were 1.96 times more likely to adhere to IFAS compared to those who were not counseled [OR:1.96, 95% CI (1.76-,5.93)]. Moreover, it showed that women who had knowledge of IFAS were 2.71 times more likely to have compliance with IFAS as compared to those who had no knowledge of IFAS [OR:2.71, 95% CI (1.33,5.54)]. Also it revealed that those women who had knowledge of anemia were 5.42 times more likely to have compliance with IFAS as compared with those who had no knowledge of anemia [OR5.42, 95% CI (1.52, 19.43)]. Furthermore, women who had received fourth visit for ANC were 1.54 times more likely to have compliance with IFAS as compared to those who had not received for ANC [OR 1.54, 95% CI (0.66, 3.58.43)]. Conclusions Our finding from this systematic review and meta-analysis shows the low case in prevalence of compliance to IFAS among pregnant women in SSA. Predictors for this includes: knowledge about anemia, knowledge about IFAS, counseling on IFAS and receiving fourth antenatal care visit were statistically correlated positively with compliance to IFAS. This demands careful appraisal of effect of prevention work for functioning policy, programs and plan nutrition intrusions for refining maternal dietary intake in gestation. Also dietary education intrusion requires to be planned to satisfy the needs of pregnant women. So we hope that the result of this study might be essential as a bridging stone for policy makers of Africa; exclusively for maternal and child health care. Finally, we recommended further studies to be conducted in the area of the study for more intensive and detailed suggestions.

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Effect of community based health education on knowledge and attitude towards iron and folic acid supplementation among pregnant women in Kiambu County, Kenya: A quasi experimental study

PLoS ONE ◽

10.1371/journal.pone.0224361 ◽

2019 ◽

Vol 14 (11) ◽

pp. e0224361 ◽

Cited By ~ 2

Author(s):

Mary Kamau ◽

Waithira Mirie ◽

Samuel Kimani ◽

Isaac Mugoya

Keyword(s):

Experimental Study ◽

Folic Acid ◽

Health Education ◽

Pregnant Women ◽

Folic Acid Supplementation ◽

Community Based ◽

Acid Supplementation ◽

Quasi Experimental ◽

Iron And Folic Acid ◽

Knowledge And Attitude

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Population-level effective coverage of adolescent weekly iron and folic acid supplementation is low in rural West Bengal, India

Public Health Nutrition ◽

10.1017/s1368980020000932 ◽

2020 ◽

Vol 23 (15) ◽

pp. 2819-2823

Author(s):

Christopher R Sudfeld ◽

Rajesh Kumar Rai ◽

Anamitra Barik ◽

Joseph J Valadez ◽

Wafaie W Fawzi

Keyword(s):

Folic Acid ◽

Adolescent Girls ◽

West Bengal ◽

Folic Acid Supplementation ◽

Cross Sectional Survey ◽

Effective Coverage ◽

Acid Supplementation ◽

School Girls ◽

Iron And Folic Acid ◽

Out Of School

AbstractObjective:To assess the coverage of the adolescent weekly iron and folic acid supplementation (WIFS) programme in rural West Bengal, India.Design:We conducted a population-based cross-sectional survey of intended WIFS programme beneficiaries (in-school adolescent girls and boys and out-of-school adolescent girls).Setting:Birbhum Health and Demographic Surveillance System.Participants:A total of 4448 adolescents 10–19 years of age participated in the study.Results:The percentage of adolescents who reported taking four WIFS tablets during the last month as intended by the national programme was 9·4 % among in-school girls, 7·1 % for in-school boys and 2·3 % for out-of-school girls. The low effective coverage was due to the combination of large deficits in WIFS provision and poor adherence. A large proportion of adolescents reported they were not provided any WIFS tablets in the last month: 61·7 % of in-school girls, 73·3 % of in-school boys and 97·1 % of out-of-school girls. In terms of adherence, only 41·6 % of in-school girls, 38·1 % of in-school boys and 47·4 % of out-of-school girls reported that they consumed all WIFS tablets they received. Counselling from teachers, administrators and school staff was the primary reason adolescents reported taking WIFS tablets, whereas the major reasons for non-adherence were lack of perceived benefit, peer suggestion not to take WIFS and a reported history of side effects.Conclusions:The effective coverage of the WIFS programme for in-school adolescents and out-of-school adolescent girls is low in rural Birbhum. Integrated supply- and demand-side strategies appear to be necessary to increase the effective coverage and potential benefits of the WIFS programme.

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Effect of time of initiation and dose of prenatal iron and folic acid supplementation on iron and folate nutriture of Korean women during pregnancy

American Journal of Clinical Nutrition ◽

10.1093/ajcn/82.4.843 ◽

2005 ◽

Vol 82 (4) ◽

pp. 843-849 ◽

Cited By ~ 19

Author(s):

Jong-Im Lee ◽

Jeong-A Lee ◽

Hyeon-Sook Lim

Keyword(s):

Folic Acid ◽

Folic Acid Supplementation ◽

Korean Women ◽

Acid Supplementation ◽

Iron And Folic Acid

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Adherence to Iron-Folate Supplementation and Associated Factors among Pastoralist’s Pregnant Women in Burji Districts, Segen Area People’s Zone, Southern Ethiopia: Community-Based Cross-Sectional Study

International Journal of Reproductive Medicine ◽

10.1155/2018/2365362 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Negussie Boti ◽

Tezera Bekele ◽

Wanzahun Godana ◽

Eskeziyaw Getahun ◽

Feleke Gebremeskel ◽

...

Keyword(s):

Folic Acid ◽

Pregnant Women ◽

Associated Factors ◽

Folic Acid Supplementation ◽

Deficiency Anemia ◽

Southern Ethiopia ◽

Acid Supplementation ◽

Iron And Folic Acid ◽

Iron Folic Acid Supplementation ◽

Iron Folic Acid

Background. Iron deficiency anemia among pregnant women is one of the most common public health problems in developing country particularly in Ethiopia. Iron/folic acid supplementation with optimal adherence is the main cost-effective strategy for prevention and control of iron deficiency anemia in pregnant women. However, level of adherence to iron/folic acid supplementation and its associated factors were not well identified in study area. Therefore, the aim of this study was to determine the level of adherence to iron/folic acid supplementation and associated factors among pregnant women in Burji Districts, southern Ethiopia. Methods. A community-based cross-sectional study was conducted among 317 pregnant women in Burji Districts from March to April 2017 using interviewer administered questionnaires. Data were entered into Epi Info 3.5.1 and exported to SPSS version 20.0 for analysis. Binary and multivariable logistic regression was used to identify factors associated with iron/folic acid supplementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value <0.05 were used to declare statistical significance. Results. Among women participating in the study, 163(51.4%) were adherent to iron/folate acid supplementation. Factors significantly associated with adherence to iron and folic acid supplementation were maternal educational status (AOR: 2.47, 95% CI: 1.13-4.97), early registration for ANC (AOR: 2.49, 95% CI: 1.45 – 4.27), history of anemia during current pregnancy (AOR: 2.02, 95% CI: 1.09-3.72), and knowledge about iron and folic acid supplementation (AOR: 1.96, 95% CI: 1.02-3.76). Forgetfulness and fear of side effects were among the leading reasons of pregnant women for nonadherence to iron and folic acid supplementation. Conclusions. This study revealed that adherence to iron /folic acid supplementation was found to be 51.4%. Maternal educational status, early registration for ANC, history of anemia during current pregnancy, and knowledge about iron and folic acid supplementation were significant factors associated with adherence to iron/folic acid supplementation among pastoralist’s pregnant women. Therefore, anemia prevention strategy should include strengthening giving awareness, counseling, strengthening community health education, and participation in health programs which are necessary to improve the uptake of iron/folic acid supplements.

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