Maternal and health care determinants of preconceptional use of folic acid supplementation in France: results from the 2010 National Perinatal Survey

Background: Anemia is a major public health problem especially in adolescent age group because of its intergenerational impact. The Ministry of Health and Family Welfare, India launched the weekly iron and folic acid supplementation programme for adolescent girls and boys. The objectives of the study were to study the awareness of the weekly iron and folic acid supplementation in preventing anemia in the study subjects; to assess the implementation of the weekly iron and folic acid supplementation in government schools and anganwadi centres.Methods: A cross-sectional study was carried out in the 4 government schools and 11 anganwadi centres of the urban field practising area of a tertiary health care centre, Osmania Medical College, Hyderabad. All the students who were present at the time of study, the teachers and anganwadi workers, who gave consent were included. The study was carried out for a period of 3 months (August to October, 2018) using a pretested schedule.Results: A total of 313 students, 21 teachers and 10 anganwadi workers had participated in the study. Among school students, only 15% had awareness of anemia. Girls had better knowledge than boys (p<0.05). The benefits of iron folic acid tablets were known to 17% students and 67% teachers. Most commonly side effects were nausea, vomiting and stomach pain. Irregular supply of tablets and poor maintainence of records was seen.Conclusions: The supply and distribution of tablets was found to be not in accordance with the guidelines of the programme.There is need of regular orientation to the teachers and anganwadi workers and nutrition education meetings for behaviour change communication to the parents.

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Effect of Weekly versus Daily Iron and Folic Acid Supplementation on the Haematological Status of Pregnant Women

Bangladesh Medical Journal ◽

10.3329/bmj.v39i3.9944 ◽

1970 ◽

Vol 39 (3) ◽

Author(s):

N Haque ◽

A Karim ◽

AKM Nurul Anwar

Keyword(s):

Health Care ◽

Folic Acid ◽

Pregnant Women ◽

Health Care Services ◽

Folic Acid Supplementation ◽

Haematological Parameters ◽

Acid Supplementation ◽

Treatment Groups ◽

Care Services ◽

Iron And Folic Acid

In many developing countries including Bangladesh daily iron and folic acid supplement is given to pregnant women through health care services but with limited success. Poor compliance, inefficiency of health care services and poor quality of supplemented tablets have been implicated for such poor outcome. Several studies reported that once or twice weekly instead of daily supplementation were equally effective with reduced gastrointestinal side effects and improved patient compliance. In this study effect of once weekly administration of 120 mg of iron and 0.5 mg of folic acid was compared with same dose of daily iron and folic acid supplementation. 600 anemic pregnant women (Hb level at or below 11.9 g/ dl) at 20 weeks±15 days of pregnancy were randomly selected and allocated to one of the two treatment groups. Haematological parameters (Blood Hb, MCV and MCHC) were measured at baseline and repeated at 28th week, 36th weeks ofpregnancy and at delivery. Because of significant drop out at antenatal visits, only 57 subjects (25 in daily group and 32 in weekly group) could be followed up till delivery at the hospital. At baseline, no significant differences in haematological parameters existed between the two treatment groups except for MCV, suggesting that study participants in both groups had more or less similar haematological status at baseline. With iron and folic acid supplementation from 20th week ±15 days of pregnancy through delivery, there had been significant improvement in both Hb level and MCV in both the groups and the improvement was not significantly different between the two groups, suggesting that both weekly and daily supplementation had similar effects. Significance of this and other findings have been discussed. Further studies with larger samples have been suggested before recommending weekly supplementation for routine use.DOI: http://dx.doi.org/10.3329/bmj.v39i3.9944 BMJ 2010; 39(3)

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