Thanks are also due to Dr Davina Ghersi for her technical advice and Daily oral iron and folic acid supplementation is recommended as part of the antenatal .. the plausible relationships between inputs and expected MDGs by applying the. Ferrous sulfate and folic acid is used to treat iron deficiency anemia (a Do not give ferrous sulfate to a child without the advice of a doctor. Folic acid is a vitamin and iron is a mineral, but your body needs both of these nutrients. Each serves a different purpose critical for life.
Despite efforts to control anaemia in pregnancy by adopting Iron and Folic Acid Supplementation IFASthis public health problem has persisted contributing to significant morbidity and mortality. The problem notwithstanding, there is poor IFAS compliance, whose reasons remain poorly understood, calling for their investigations. We sought to determine compliance status with IFAS and associated factors among pregnant women. Using two stage cluster sampling, one Sub-County and five public health facilities in Kiambu County were selected.
All pregnant women attending antenatal clinics who met inclusion criteria and consented to participate in the study were recruited. A structured interviewer-administered questionnaire consisting of sociodemographic data, IFAS maternal knowledge and compliance practices was pretested and administered. Results Of the respondents interviewed, Of those with high IFAS knowledge, Women who were multigravid These underscore the need for approaches to scale up health awareness on the benefits of IFAS, mitigation measures for the side effects, as well as targeted counselling.
Compliance, Iron and folic acid supplementation, Pregnancy, Anaemia, Advice Plain english summary Lack of minute nutrients required in small amounts in the body is common in Kenya especially at important stages of life such as pregnancy.
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These can negatively affect growth and development of both mothers and their children. Lower than normal blood levels during pregnancy persist in Kenya contributing to death of one out of ten women and two out of ten infants. Despite provision of iron and folate supplements at no cost to all pregnant women in all government health facilities to help prevent these low blood levels, their use has been continually limited over the years. This study looked at consistency of women in using these daily supplements and factors influencing their use.
This study was conducted among pregnant women of child-bearing age in five public health facilities of one sub-County in Kiambu County, Kenya. A questionnaire was used to collect data from pregnant women. Of all pregnant women interviewed, only a third were consistently using the supplements.
Gaps were identified in content of counselling emphasizing need to integrate other strategies like community based health education and focused counselling to increase supplement use. Background Iron and folic acid are essential micronutrients for normal physiological function, growth and development as well as maintenance of life. Like many other nutrients, their demand increases during pregnancy creating a need for supplementation to meet daily requirement in pregnancy [ 1 ]. Due to this disproportion, deficiency in iron or folic acid causes an imbalance between demand and supply resulting in anaemia.
Iron and folic acid and other micronutrient deficiencies are highly prevalent in Kenya, particularly at crucial stages of the life cycle such as pregnancy which can negatively impact the health of both mothers and children, before, during and after birth [ 34 ].
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Pregnancy-related anaemia remains top among the leading causes of global health burden [ 5 ], with more than half attributed to iron deficiency [ 67 ], and the most common form of micronutrient malnutrition and prevalent nutritional deficiency leading to significant morbidity and mortality globally [ 7 — 10 ]. The global prevalence of pregnancy-related anaemia spans from Indeed, in developing countries, every second pregnant woman is estimated to be anaemic [ 7 ]. In Kenya, despite efforts to control and prevent anaemia in pregnancy, this public health problem persists, with a national prevalence of The prevalence are similar to those found in Asia, where the problem is the second highest cause of maternal mortality [ 14 ].
Iron and folic acid supplementation IFAS during pregnancy has been recommended as one of the strategies to address this public health problem.
It is an affordable and effective global strategy for prevention and control of anaemia during pregnancy resulting in reduced maternal-child morbidity and mortality [ 31315 ]. IFAS is offered routinely to all antenatal mothers attending public health facilities, at no cost.
One of the major reasons cited for poor IFAS response is poor compliance [ 1523 ], due to the requirement of daily supplementation [ 24 ]. It has been found that those who need the supplements most, comply the least [ 26 ]. Many factors have been reported to affect IFAS compliance, notably health sector and client related issues, affecting and causing a lack of demand from both health sector and clients [ 27 ]. Study locations and populations We conducted the fieldwork in two villages, one in Mymensing and one in Netrokona— two of the five districts included in the Shonjibon Trial— located in north-central Bangladesh.
One village in each district was selected for the study. One of the authors SR and the formative research field staff consulted the district managers of the BRAC Health Programme to identify one Upazilla sub-district from each district in which to conduct the fieldwork.
The selected Upazillas best represented their districts in terms of demography, distance from the district office of the NGOs headquarters, and availability of health services from the Government and NGOs. The research team then consulted with the respective NGO Health Programme Managers to select one village in each Upazilla for data collection.
Stratified purposeful and opportunistic sampling [ 24 ] strategies were used to select the respondents. The pregnant women were selected for the in-depth interviews from the registers of the SKs based on their parity primipara or multipara and their use of IFA tablets user or non-user. All the mothers or mothers-in-law of the pregnant women were also approached for interview. When neither the mother-in-law nor the mother was present, the interviewer interviewed an older female of the family who played a similar role to the mother-in-law or mother.
All the participants of the study provided written consent and the study received ethical clearance from the Ethical Review Committee of the International Centre for Diarrhoeal Disease Research, Bangladesh.
Data analysis All the interviews were audio-recorded and transcribed in Bangla for analysis by the researchers themselves. The data obtained were manually coded for emerging themes. Themes were triangulated using data collected through various qualitative methods. Peer debriefing was conducted within the study team to help understand the issues and consolidate the findings.
Results Perceptions related to pregnancy and childbirth Birth weight and size In the community, people did not aspire for a certain weight for their babies and, therefore, showed no concern about birth weight. The pregnant women and their mothers-in-law were concerned about having a healthy baby rather than aspiring for a baby of a certain weight. Pregnant women were more concerned about caring for a baby after its birth than by its weight at birth: Life and death [of a baby] is in the hands of Allah sic.
Discussion among family members about the size and weight of the baby at birth was hindered by perceptions that by articulating aspirations about the unborn child, respondents may bring misfortune to the mother or the infant. One pregnant woman explained: Suppose I eat adequate fruits, then the baby in my belly will receive it sic.
If I drink a lot of milk, the baby [in my belly] will get the milk. Women were aware of the need to eat normal food during pregnancy. Most pregnant women and elderly women knew of food taboos during pregnancy. Physical appearance of a food played a role in its description as harmful. For example, coconut and coconut water, if consumed during pregnancy, were said to make the eyes of the baby white blind.
They usually deferred to the knowledge of older women in the family. However, some husbands thought that eating too much rice during pregnancy could reduce the size of the baby, as a full stomach left little space for the foetus to grow.
This perception was also prevalent among mothers-in-law and mothers of the pregnant women. As one husband explained with a livestock analogy, We know if a pregnant woman eats much sic the baby inside her tummy will be smaller, for example, if you feed a cow too much food [during pregnancy], it will deliver a small calf.
Medication and movement during pregnancy Some specific restrictions about taking medicine during pregnancy were mentioned.Amazing Benefits Of Folic Acid For Skin And Hair │ 5 Health Benefits Of Folic Acid
Pregnant women mentioned that medication for fever and worms during pregnancy could cause abortion and stillbirth. Women believed that going out of the house during certain times of the day and on certain days of the week was harmful for pregnant women. For example, respondents considered noon, sunset, and after the call for evening prayer esher aajan to be harmful times.
Some considered Saturday and Tuesday to be harmful for pregnant women to be out of the house. Further, it was considered shameful to display the state of pregnancy to men outside the family.
These perceptions reduced the mobility of the pregnant women. However, many women were aware of the benefits of antenatal intake of iron supplements. Women who used IFA tablets during pregnancy reported more strength, increased blood volume, and reduced physical weakness.
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The family members of users of IFA tablets perceived that antenatal IFA supplementation increases blood volume and cleans the blood rokto baraye and rokto porishkar kore for pregnant women.
There was a common belief that during pregnancy women share their blood with the foetus leaving less blood available for the mother.
IFA tablets were believed to make up for this deficiency. As one pregnant respondent said, One should take iron tablet [during pregnancy]. When there is a baby in the tummy, the volume of blood is reduced in the body.
So iron tablet sic should be taken to make up this deficiency. Some respondents believed that taking IFA tablets reduced nutrient deficiency and helped recovery from blood loss during pregnancy. According to one elderly woman, We are poor people. Mother loses this amount of blood.
If she takes iron tablets, she can recover this loss.
Pregnant women's age and parity was a factor for some differences of opinion among about IFA.