Toward Better Compliance with Iron–folic Acid Supplements: Understanding the Behavior of Poor Urban Pregnant Women through Ethnographic Decision Models in Vadodara, India

2002 ◽  
Vol 23 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Jai Ghanekar ◽  
Shubhada Kanani ◽  
Sucheta Patel
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Decision Models ◽  
Folic Acid Supplements ◽  
Iron Folic Acid

scholarly journals ASSOCIATION BETWEEN KNOWLEDGE AND COMPLIANCE OF TAKING IRON/FOLIC ACID SUPPLEMENTS DURING PREGNANCY

2017 ◽  
Vol 10 (17) ◽  
pp. 177 ◽  
Author(s):  
Christiana R Titaley ◽  
Enrika Rahayu ◽  
Rita Damayanti ◽  
Dini Dachlia ◽  
Ratu Ayudewi Sartika ◽  
...  
Keyword(s):  
Folic Acid ◽  
Side Effects ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Deficiency Anemia ◽  
Cross Sectional ◽  
Community Based Education ◽  
Folic Acid Supplements ◽  
Improve Compliance ◽  
Iron Folic Acid

 Objective: In Indonesia, pregnant women are recommended to take a minimum of 90 tablets of iron/folic acid (IFA), to prevent iron deficiency anemia. Our analysis aimed at examining the extent to which improved knowledge on IFA supplementation is associated with women’s compliance with taking a minimum of 90 IFA tablets during their last pregnancy in four districts in Indonesia.Methods: Data were derived from a cross-sectional study conducted in four districts, that is, Lebak and Pandeglang District (Banten Province) as well as Purwakarta and Subang District of West Java Province, Indonesia on June 2014. We used information from 436 mothers who delivered their baby in the last 6 months from the time of the survey and received at least 90 IFA tablets during her last pregnancy. Logistic regression analysis was used to examine the role of knowledge after controlling for confounders and other significant predictor on compliance with taking a minimum of 90 IFA tablets during pregnancy.Result: Significant association was found between knowledge of IFA supplements and compliance. Compared to women with poor knowledge of IFA supplementation, the odds of taking a minimum of 90 IFA tables increased by almost 100% in women with moderate knowledge (adjusted odd ratio [aOR]=1.96, 95% confidence interval [CI]: 1.17-3.30, p=0.011); and by more than four times (aOR=5.42, 95% CI: 1.76-16.68, p=0.003) in women with good knowledge of IFA supplementation. Other factors associated with compliance was attendance in at least four antenatal services (aOR=5.71, 95% CI: 1.28-25.53, p=0.023) and pregnant women experience of no side effects resulting from taking IFA tablets during pregnancy (aOR=2.70, 95% CI: 1.63-4.46, p<0.001).Conclusions: Efforts to increase women’s knowledge on IFA supplementation through community-based education will increase women’s compliance of taking IFA supplements. Strengthening counseling services on potential side effects of IFA supplementation and ways to manage them will also help to improve compliance.

scholarly journals Utilization of preconception care and its impacts on health behavior changes among expectant couples in Shanghai, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Du ◽  
Xuena La ◽  
Liping Zhu ◽  
Hong Jiang ◽  
Biao Xu ◽  
...  
Keyword(s):  
Folic Acid ◽  
Child Health ◽  
Health Behavior ◽  
Pregnant Women ◽  
Preconception Care ◽  
Behavior Changes ◽  
Care Services ◽  
Folic Acid Supplements ◽  
Health Behavior Changes ◽  
And Child Health

Abstract Background Preconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for women and their offspring. Preconception care has been established in maternal and child health hospitals in Shanghai, China, which consists of health checkups, health education and counseling. This study investigated factors associated with the utilization of preconception care, and the role of preconception care on health behavior changes before conception among pregnant women and their partners. Methods A cross-sectional study was conducted among pregnant women at three maternal and child health hospitals in Shanghai. The participants were invited to complete a self-administered questionnaire on the utilization of preconception care and health behavioral changes before conception. Results Of the 948 recruited pregnant women, less than half (42.2%) reported that they had utilized preconception care before the current pregnancy. Unplanned pregnancy, unawareness of preconception care and already having a general physical examination were the main reasons for not attending preconception care. The two main sources of information about preconception care were local community workers and health professionals. Younger women and the multipara were less likely to utilize preconception care. Women who utilized preconception care were more likely to take folic acid supplements before conception [Adjusted Odds Ration (aOR) 3.27, 95% Confidence Interval (CI) 2.45–4.36, P < 0.0001]. The partners of pregnant women who had attended preconception care services were more likely to stop smoking [aOR 2.76, 95%CI 1.48–5.17, P = 0.002] and to stop drinking [aOR 2.13, 95%CI 1.03–4.39, P = 0.041] before conception. Conclusions Utilization of preconception care was demonstrated to be positively associated with preconception health behavior changes such as women taking folic acid supplements before pregnancy, their male partner stopping smoking and drinking before conception. Future studies are needed to explore barriers to utilizing preconception care services and understand the quality of the services. Strategies of promoting preconception care to expectant couples, especially to young and multipara women, should be developed to further improve the utilization of the services at the community level.

Effect of routine iron–folic acid supplementation among rural pregnant women living in low- and high-groundwater-iron areas in Bangladesh

2019 ◽  
Vol 22 (15) ◽  
pp. 2844-2855 ◽  
Author(s):  
Faruk Ahmed ◽  
Moududur Rahman Khan ◽  
Ireen Akhtar Chowdhury ◽  
Rubhana Raqib ◽  
Anjan Kumar Roy ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Significant Proportion ◽  
Significant Risk ◽  
Folic Acid Supplementation ◽  
Fe Deficiency ◽  
Prospective Longitudinal Study ◽  
Iron Folic Acid ◽  
Hb Concentration ◽  
Prospective Longitudinal

AbstractObjective:The present study investigated the risks and benefits of routine Fe–folic acid (IFA) supplementation in pregnant women living in low- and high-groundwater-Fe areas in Bangladesh.Design:A case-controlled prospective longitudinal study design was used to compare the effect of daily Fe (60 mg) and folic acid (400 μg) supplementation for 3·5 months.Setting:A rural community in Bangladesh.Participants:Pregnant women living in low-groundwater-Fe areas (n 260) and high-groundwater-Fe areas (n 262).Results:Mean Hb and serum ferritin concentrations at baseline were significantly higher in pregnant women in the high-groundwater-Fe areas. After supplementation, the mean change in Hb concentration in the women in the low-groundwater-Fe areas (0·10 mg/dl) was higher than that in the pregnant women in the high-groundwater-Fe areas (–0·08 mg/dl; P = 0·052). No significant changes in the prevalence of anaemia or Fe deficiency (ID) in either group were observed after IFA supplementation; however, the prevalence of Fe-deficiency anaemia (IDA) decreased significantly in the women in the low-groundwater-Fe areas. The risk of anaemia, ID and IDA after supplementation did not differ significantly between the groups. None of the participants had Fe overload. However, a significant proportion of the women in the high- and low-groundwater-Fe areas remained anaemic and Fe-deficient after supplementation.Conclusion:IFA supplementation significantly increased the Hb concentration in pregnant women living in the low-groundwater-Fe areas. Routine supplementation with 60 mg Fe and 400 μg folic acid does not pose any significant risk of haemoconcentration or Fe overload. Further research to identify other nutritional and non-nutritional contributors to anaemia is warranted to prevent and treat anaemia.

scholarly journals Use of high doses of folic acid supplements in pregnant women in Spain: an INMA cohort study

BMJ Open ◽  
2015 ◽  
Vol 5 (11) ◽  
pp. e009202 ◽  
Author(s):  
Eva María Navarrete-Muñoz ◽  
Desirée Valera-Gran ◽  
Manoli García de la Hera ◽  
Daniel Gimenez-Monzo ◽  
Eva Morales ◽  
...  
Keyword(s):  
Cohort Study ◽  
Folic Acid ◽  
Pregnant Women ◽  
Folic Acid Supplements ◽  
High Doses

scholarly journals Misdistributions of Iron-Folic Acid (IFA): a Major deterrent to combat Anemia in Pregnant Women

2015 ◽  
Author(s):  
Dr M.K. Sharma ◽  
◽  
Dr Neeraj Gour ◽  
Dr N.K. Goel ◽  
Dr Dinesh Walia ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Iron Folic Acid

scholarly journals Transitioning from Distribution of Iron-Folic Acid Supplements to Multiple Micronutrient Supplements for Pregnant Women (OR25-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Reina Engle-Stone ◽  
Stephen Vosti ◽  
Laura Meinzen-Dick ◽  
Sika Kumordzie
Keyword(s):  
Folic Acid ◽  
Preterm Birth ◽  
Cost Effectiveness ◽  
Burkina Faso ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Transition Costs ◽  
Multiple Micronutrient ◽  
Iron Folic Acid ◽  
The Cost

Abstract Objectives We aimed to estimate the potential effects, costs, and cost-effectiveness of a programmatic transition from distribution of iron-folic acid (IFA) tablets to distribution of multiple micronutrient supplements (MMS) to pregnant woman, using Bangladesh and Burkina Faso as case studies. Methods For each country, we developed an 11-year predictive model using baseline demographic information from the Lives Saved Tool and effect sizes from a recent meta-analysis of trials of MMS compared to IFA supplementation during pregnancy. We predicted the number of cases of stillbirth, infant mortality, and adverse birth outcomes (low birth weight, small-for-gestational age, and preterm birth) and DALYs averted by replacing IFA with MMS at current levels of IFA coverage (∼50% nationally in Bangladesh; ∼10% in Burkina Faso). We estimated initial program transition costs and the annual marginal cost of MMS compared to IFA supplements, and calculated cost-effectiveness measures for scenarios with varied numbers of tablets received and consumed by pregnant women. Results In Bangladesh, immediate replacement of IFA with MMS at current coverage (assuming all covered pregnancies receive 180 tablets) was predicted to avert >73,800 deaths and >178,500 cases of preterm birth over 11 years at a cost of $5.0 to $14.2 per DALY averted; costs would increase by ∼9% with the addition of programmatic transition costs. In Burkina Faso, the same scenario would avert >5700 deaths and >6600 cases of preterm birth over 11 years at a cost of $3.6 to $15.5 per DALY averted. Assuming that benefits of supplementation accrue only above a given threshold (e.g., 180 tablets per pregnancy), accounting for supplement consumption above or below this threshold (e.g., consumption of 30 tablets or 270 tablets) could substantially reduce the cost-effectiveness of the IFA-MMS switch in comparison with a scenario in which all covered pregnancies consume exactly 180 tablets, although cost per DALY averted remained below $105 in all scenarios. Conclusions This modeling analysis suggests that the cost per DALY averted by transitioning from IFA to MMS is low relative to other prenatal interventions designed to save lives. Improvements in program delivery and supplement adherence would improve the cost-effectiveness of replacing IFA with MMS. Funding Sources Sight and Life; Sackler Institute for Nutrition Science.

scholarly journals Weekly iron–folic acid supplements containing 2.8 mg folic acid are associated with a lower risk of neural tube defects than the current practice of 0.4 mg: a randomised controlled trial in Malaysia

2020 ◽  
Vol 5 (12) ◽  
pp. e003897
Author(s):  
Kaitlyn L I Samson ◽  
Su Peng Loh ◽  
Siew Siew Lee ◽  
Dian C Sulistyoningrum ◽  
Geok Lin Khor ◽  
...  
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Controlled Trial ◽  
Clinical Trial Registry ◽  
Double Blind ◽  
Folic Acid Supplements ◽  
Registration Number ◽  
Menstruating Women ◽  
Iron Folic Acid ◽  
Randomised Controlled

IntroductionWeekly iron–folic acid (IFA) supplements are recommended for all menstruating women in countries where anaemia prevalence is >20%. Anaemia caused by folate deficiency is low worldwide, and the need to include folic acid is in question. Including folic acid might reduce the risk of a neural tube defect (NTD) should a woman become pregnant. Most weekly supplements contain 0.4 mg folic acid; however, WHO recommends 2.8 mg because it is seven times the daily dose effective in reducing NTDs. There is a reluctance to switch to supplements containing 2.8 mg of folic acid because of a lack of evidence that this dose would prevent NTDs. Our aim was to investigate the effect of two doses of folic acid, compared with placebo, on red blood cell (RBC) folate, a biomarker of NTD risk.MethodsWe conducted a three-arm double-blind efficacy trial in Malaysia. Non-pregnant women (n=331) were randomised to receive 60 mg iron and either 0, 0.4, or 2.8 mg folic acid once weekly for 16 weeks.ResultsAt 16 weeks, women receiving 0.4 mg and 2.8 mg folic acid per week had a higher mean RBC folate than those receiving 0 mg (mean difference (95% CI) 84 (54 to 113) and 355 (316 to 394) nmol/L, respectively). Women receiving 2.8 mg folic acid had a 271 (234 to 309) nmol/L greater mean RBC folate than those receiving 0.4 mg. Moreover, women in the 2.8 mg group were seven times (RR 7.3, 95% CI 3.9 to 13.7; p<0.0001) more likely to achieve an RBC folate >748 nmol/L, a concentration associated with a low risk of NTD, compared with the 0.4 mg group.ConclusionWeekly IFA supplements containing 2.8 mg folic acid increases RBC folate more than those containing 0.4 mg. Increased availability and access to the 2.8 mg formulation is needed.Trail registration numberThis trial is registered with the Australian New Zealand Clinical Trial Registry (ACTRN12619000818134).

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