ABSTRACT
Background: Iron-folic acid deficiency is the most common complication during pregnancy. Iron deficiency is responsible for various health complications among pregnant women. Compliance with IFA supplementation is variable across India several factors are associated with compliance with IFA supplementation. Objective: The objective of this systematic review is to assess the factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. Methods: The primary search was carried out using PubMed, Google scholar, the WHO website, and Research Gate which provide access to full?text research articles from January 2012 to 25th January 2022 published data were searched. Result: A total of 74 studies were identified, and 20 were included in this review. Out of the 20 studies, sixteen were cross-sectional, two mixed methods, and two randomized control trials. knowledge of IFA, education, socioeconomic status, the timing of registration and number of antenatal visits, type of family, and age of the pregnant women were the factors that affect the compliance of IFA supplementation. Conclusion: Knowledge of iron-folic acid supplementation, Timing of registration and number of Antenatal Care visits, educational level of the pregnant women, and age of the pregnant women were factors associated with the compliance of IFA supplementation among pregnant women in India.
ABSTRACT
Background: National Family Health Surveys in India have not included nutritional status of the crucial age group of 10-14 years, when pubertal growth spurt typically occurs. BMI-for-age is commonly used to assess adolescent nutritional status which may misclassify stunted adolescents as normal or overweight. Objectives: To estimate prevalence and determinants of stunting among adolescents (10 to 19 years) in Bangalore city and to estimate the proportion of adolescents who are stunted, but otherwise assessed as normal or overweight using BMI-for-age. Methods: Cross sectional study conducted in four schools of Bangalore city using a self-administered questionnaire to capture socio-demographic details, dietary patterns and physical activity. WHO Anthroplus software was used to classify nutritional status based on height-for-age and BMI-forage. Multiple logistic regression analysis was done to calculate adjusted odds ratios of independent co-variates associated with stunting. Results: Overall prevalence of stunting was 14% (95%CI:11.5-16.5%); 14.3% among females (95%CI:10.7-17.9%) and 13.6% among males (95%CI: 10.2-17.0%). Determinants of stunting were late adolescence [AOR=1.90(1.24-2.90),P=0.03], lower socio-economic class [AOR=2.75(1.39-5.41),P=0.03] and not taking weekly iron and folic acid supplements [AOR=2.78(1.48-5.21),P=0.001] Four of every five stunted children (81%) were classified as normal/ overweight/ obese using BMI-for-age. Conclusion: Stunting is a problem among urban adolescents in Bangalore. Height-for-age is a vital metric for assessing nutritional status of adolescents along with other metrics. We recommend strengthening of weekly iron and folic acid supplementation in schools and culturally specific targeted nutritional interventions for adolescents from economically weaker sections of society using a multi-sectoral and participatory approach.
ABSTRACT
@#Introduction: Indonesia has initiated the weekly iron-folic acid supplementation programme (WIFS) among adolescent school girls since 2016. However, its acceptability needs to be investigated. This study aimed to assess the acceptability of WIFS and its influencing factors. Methods: A mixed-methods study was conducted in six schools in Yogyakarta from January-April 2018. Totally, 211 participants aged 12-18 years were involved in the cross-sectional survey, followed by four focus group discussions (FGDs) and in-depth interviews (IDIs). Body mass index-for-age, haemoglobin, serum ferritin, habitual intake, and acceptability (defined as selfreported iron folic acid tablet consumption) were assessed. Results: This study reported that 22.3% and 12.4% of the participants were categorised as iron deficient and anaemic, respectively. Almost 90% of participants had received the tablet, but only 62.0% of them reported consuming it. Logistic regression test indicated that the participants were more likely to take the tablet if it tasted good [OR (95%CI): 4.66 (1.90-11.43)]. Meanwhile, motivation for tablet consumption declined when respondents perceived the odour of tablet was unpleasant, reported forgetfulness, lacked peer support, and experienced side effects, with OR (95%CI) of 0.23 (0.07- 0.77), 0.35 (0.13-0.95), 0.30 (0.08-0.58), and 0.04 (0.04-0.39), respectively. The results from FGD and IDIs strengthened the findings that the experience of nausea, organoleptic properties of iron-folic acid tablet, forgetfulness, and mother’s support play important roles in students’ acceptability. Conclusion: This study found moderate acceptability towards the WIFS programme. The inhibiting and reinforcing factors of WIFS acceptability in this study could be considered as inputs for programme improvements in the future.
ABSTRACT
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.
ABSTRACT
Background: Iron deficiency anemia is a public health alarm in developing countries. Anemia is an indicator of both poor health and poor nutrition. It has been observed that iron deficiency anemia in children and adolescent leads to growth delay. Weekly iron folic acid (WIFS) with health education can significantly reduce prevalence of nutritional anemia and improve growth among adolescents is seen elsewhere in the World. To confirm these results in India, a study was conducted in Delhi to investigate the effect of WIFS and Health education on growth in adolescent school girls.Methods: A school based intervention study was conducted in selected government schools of Delhi. Total of 210 adolescent school girls (11th standard) were included in the study, 106 in intervention group and 104 in control group. The intervention group was given weekly iron folic acid supplementation (WIFS) with health education once a month, while a control group was given only WIFS.Results: A significant weight gain of 2.8 kg was seen in the intervention group, whereas girls in the control group showed 1.8 kg weight gain. The growth increment was greater in the intervention group than control group which was found to be statistically significant (p<0.01).Conclusions: WIFS and health education is recommended for growth promotion among adolescent girls especially who are underweight. Additional programmatic research should be carried out for understanding of the WIFS with health education -growth relationships in adolescence.
ABSTRACT
Background: In India, more than half of the pregnant women suffer from anemia. Low compliance to iron supplementation is one of the important reasons. Objectives: The objective of the study is to estimate the reduction in the prevalence of anemia, improvement in iron status, and to compare the compliance to oral iron supplementation during pregnancy between directly observed iron-folic acid (IFA) supplementation group and control group. Methods: This was a community-based open labeled parallel block-randomized controlled trial including 400 pregnant women in a rural setting of north India. In the intervention group, the first dose of IFA every week was supervised by ASHA and women were instructed to take the remaining tablets during the week as per the prescription. In control group, IFA tablets were supplemented without direct supervision. Results: After 100 days of IFA supplementation, the reduction in anemia in the intervention group was 6% higher as compared to control group (P = 0.219). The increase in the mean hemoglobin level over and above control group was 0.52 g/dl in intervention group (P < 0.001). However, the mean increase in serum ferritin level in the intervention group was similar to the control group. The mean percentage compliance in the intervention group was almost 9% higher than that of control group (P = 0.001). Conclusion: Directly supervised oral iron (IFA) supplementation improves compliance to oral iron (IFA) supplementation and also improves hemoglobin status among pregnant women. However, the mean increase in serum ferritin and reduction in the prevalence of anemia in the intervention group were not higher than the control group.
ABSTRACT
The effect of deworming vs deworming and weekly Iron-Folic acid (IFA) on growth, hemoglobin level, and physical work capacity of children was studied. Children from three rural schools studying from 4th to 7th standard were selected. One set of school children were given deworming tablet (400 mg albendezole) once in six months while the second school children received deworming tablet along with weekly dose of Iron Folic acid Tablet (60 mg of elemental iron and 0.5 mg folic acid). Anthropometric measurements, hemoglobin, and physical work capacity was estimated. No significant change was noticed in the prevalence of malnutrition or physical work capacity of the children. As compared to only deworming, IFA + Deworming showed 17.3 % increase in the hemoglobin levels (P<0.001). Thus weekly IFA along with deworming has shown beneficial effect on the hemoglobin levels of the children.