scholarly journals Re-evaluating the need for universal iron supplementation in pregnant Indian women in the light of gestational age specific low hemoglobin prevalence

2021 ◽  
Vol 33 (3) ◽  
pp. 435-439
Author(s):  
Aswathi Saji ◽  
Jeswin Baby ◽  
Anura V Kurpad ◽  
Tinku Thomas

Background: Anemia prevalence among Indian pregnant women in 2015-16 was 50.4% and has not declined from 49.7% in 1998-99 despite the national policies on iron-folic acid supplementation. New gestational age-specific cut-offs (INTERGROWTH cut-off) for risk of low Hemoglobin (Hb) have been identified. Aims and objectives: Compare prevalences of low Hb  based on WHO and INTERGROWTH cut-offs Methods: The prevalence of anemia/low Hb among pregnant women in trimesters 2 and 3 from NFHS-4 data were estimated using the current WHO recommendations and the INTERGROWTH cut-offs. Results: Prevalence of low Hb by the INTERGROWTH cut-off was 28.1%(95% CI:26.9-29.4) and 21.7%(95% CI:20.6-22.9) in trimesters 2 and 3. Anemia prevalence by WHO cut-off was much higher at 41.2%(95% CI:39.8-42.5) and 54.8%(95 CI:53.2-56.3) in trimesters 2 and 3. The prevalence of low-Hb was similar between ANC and no-ANC reported groups in both trimesters (26.1% and 28.9% in trimester-2; 20.1% and 22.4% in trimester-3). Conclusion: The  prevalence of low-Hb with gestational age specific cut-offs is much lower compared to earlier estimates using WHO cut-off. The universal iron supplementation program for pregnant women in India need to be re-examined in this light and a tragetter Hb testing based supplementation may be more beneficial in reducing anemia prevalence.

2008 ◽  
Vol 11 (6) ◽  
pp. 596-605 ◽  
Author(s):  
Binetou C Seck ◽  
Robert T Jackson

AbstractBackgroundCommunity iron supplementation programmes for pregnant women have lacked effectiveness, partly because of low compliance.ObjectiveTo determine factors that influence compliance among pregnant women in Senegal.DesignTwo hundred and twenty-one pregnant women, recruited from six health centres in Dakar during their first prenatal visit, were randomly assigned to receive either a prescription to purchase iron/folic acid tablets (control, n = 112) to be taken daily, according to official policy, or to receive free tablets (treatment, n = 109). Compliance was assessed 20 weeks after enrolment through interviews and pill count. Women with low or high compliance (<70% or ≥70%) were asked to explain what influenced their adherence to supplementation.ResultsOverall compliance was 69%; it was significantly higher in the treatment than in the control group (86% vs. 48%; P < 0.0001). Women with high compliance (58%) were motivated by: (1) the perception of improved health upon taking the tablets (treatment = 24%, control = 10%); (2) the insistence by midwives that they take the tablets; and (3) the mention that the tablets would improve health. Women with low compliance (42%) reported: (1) the experience of side-effects that they associated with the tablets (treatment = 13%, control = 14%); (2) misunderstanding that they needed to continue taking the tablets throughout pregnancy (treatment = 0%, control = 18%); and (3) forgetfulness.ConclusionCompliance with iron/folic acid supplementation in Senegal can be increased by providing women with clear instructions about tablet intake and educating them on the health benefits of the tablets.


Author(s):  
Raja Sekhar Jalemu ◽  
Kasthuribai Sabbe ◽  
Grishma Jalemu

Background: In pregnancy Anaemia and Depression is an important factor associated with an increased risk of maternal, fetal and neonatal mortality, poor pregnancy outcomes, and impaired cognitive development. To assess prevalence and factors associated with anemia and Depression among pregnant women attending antenatal clinic.Methods: A Facility based cross-sectional study was conducted on 284 pregnant women to at Rural Medical college hospital from June to August 2018. Data on sociodemographic and clinical characteristics of the study participants were collected using a Pretested structured questionnaire by interview and review of medical records. Binary Logistic regression analysis had been used to check for association between dependent and independent variables in all cases. P-value less than 0.05 was considered statistically significant.Results: The prevalence of anemia was found to be11.6% (95 %CI; 7.8%-14.8%) and Depression was 8.6% Pregnant women in the second and third trimester [AOR (95% CI), 8.31 (1.24-55.45), and P=0.029] were more likely to be anemic when compared to pregnant women in their first trimester. Pregnant women who did not receive iron/folic acid supplementation [AOR (95%CI),4.03(1.49 10.92), and P=0.01] were more likely to be anemic when compared to pregnant to women who did take supplementations.Conclusions: In this study the prevalence of anemia and Depression in pregnancy was low compared to the findings of others. Gestational age (trimester) and iron/folic acid supplementation were statistically associated with anemia. 


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Negussie Boti ◽  
Tezera Bekele ◽  
Wanzahun Godana ◽  
Eskeziyaw Getahun ◽  
Feleke Gebremeskel ◽  
...  

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.


2019 ◽  
Author(s):  
Wondwossen Niguse

AbstractIntroductionGlobally 41.8% of pregnant women are anemic with the highest proportion affected in developing countries. Nationally, only 0.4% of the pregnant women take Iron supplements more than 90 days of the recommended 180 days. In Oromiya region 75.3% of pregnant women do not take any iron tablets or syrup during their last pregnancy, while 10.8% take for less than 60 days, 0.4% took for 60-89 days and only 0.3% took for 90 days or more.ObjectiveTo assess the adherence rate to iron and folic acid supplements among pregnant women attending antenatal clinics in Asella Town, south east EthiopiaMethod and materialsInstitution based cross-sectional quantitative study design was conducted in Asella town from September 2015 to June 2016. A purposive sampling technique used to select the health institution. There are six health institutions selected for this study. The sample size 317 was selected with systematic random sampling method. Ten percent of pre-test was conducted in one institution which is not included in data collection. Data were collected using structured pre-tested questionnaire. Before data collection verbal consent was obtained. The collected data were analyzed using Epi-data and SPSS version 22.00 packages.ResultThe study revealed that Out of 317 pregnant women 296 (93%) responded to the questioner. The study revealed that 177 (59.8%) of pregnant mothers in the town adhered to the iron/folic acid supplement.Conclusion and recommendationAdherence of iron/folic acid supplementation found in this study is very low. Consequently, maternal education, adequate supplement supply to the health facility, early starting antenatal visit, and health education on duration of supplementation


2019 ◽  
Author(s):  
Tewachew Muche liyeh ◽  
Yitayal Ayalew Goshu ◽  
Amare Simegn Ayele ◽  
Yibeltal Abebe

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


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