Piloting Multiple Micronutrient Supplementation Within the Routine Antenatal Care System in Ethiopia: Insights From Stakeholders

IF 2.8 2区 医学 Q3 NUTRITION & DIETETICS
Anene Tesfa Berhanu, Atkure Defar, Girum Taye, Alemneh Kabeta Daba, Senait Alemayehu, Bedasa Tessema, Kalkidan Zenebe, Charles Opondo, Getachew Tollera, Mesay Hailu, Joanna Schellenberg, Lars Ake Persson, Tanya Marchant, Masresha Tessema
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Abstract

In low and middle-income countries, addressing maternal and child nutrition needs is crucial. Prenatal multiple micronutrient supplementation (MMS) holds promise in reducing low birthweight and preterm births. Ethiopia is considering a transition from the provision of iron-folate supplementation to the provision of MMS in antenatal care, guided by WHO guidelines. This paper explores stakeholders' early perceptions and experiences in piloting that transition in five Ethiopian regions, informing decision making about future policy and scale-up. We used a qualitative study involving interviews and document reviews to assess the MMS pilot, analyzing themes with Nvivo 12 software. Key informant interviews revealed challenges such as supply chain issues and funding constraints, along with proposed improvement strategies such as closer coordination within existing structures. The importance of engaging with communities to create demand was emphasized, as was the need for capacity-building efforts utilizing existing staff in the health system with a clear plan for ongoing refresher training. Finally, enhancing the monitoring and evaluation framework, including a dedicated regional team for supportive supervision, was vital for accountability. In conclusion, prioritizing supply chain strengthening, community engagement through demand creation, coordination, and continuous capacity building for healthcare workers were thought to be crucial for the MMS program's success.

Trial Registration

ClinicalTrials.gov Identifier: NCT05708183 Registered 01 February 2023—Retrospectively registered, https://classic.clinicaltrials.gov/ct2/show/NCT05708183.

在埃塞俄比亚的常规产前保健系统中试点多种微量营养素补充:来自利益相关者的见解。
在低收入和中等收入国家,解决孕产妇和儿童营养需求至关重要。产前补充多种微量营养素(MMS)有望减少低出生体重和早产。埃塞俄比亚正在考虑在世卫组织指南的指导下,从提供叶酸铁补充剂过渡到在产前保健中提供MMS。本文探讨了利益相关者在埃塞俄比亚五个地区试点这种转变的早期看法和经验,为未来政策和扩大规模的决策提供了信息。我们采用了包括访谈和文献回顾在内的定性研究来评估MMS试点,并使用Nvivo 12软件分析主题。关键的信息提供者访谈揭示了诸如供应链问题和资金限制等挑战,以及提出的改进策略,例如在现有结构内进行更密切的协调。强调了与社区接触以创造需求的重要性,强调了利用卫生系统现有工作人员进行能力建设工作的必要性,并为正在进行的进修培训制定了明确的计划。最后,加强监测和评价框架,包括一个专门的区域支助监督小组,对问责制至关重要。总之,优先加强供应链、通过创造需求进行社区参与、协调和医疗工作者的持续能力建设被认为是MMS项目成功的关键。试验注册:ClinicalTrials.gov标识符:NCT05708183注册日期:2023年2月1日-回顾性注册,https://classic.clinicaltrials.gov/ct2/show/NCT05708183。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Maternal and Child Nutrition
Maternal and Child Nutrition 医学-小儿科
CiteScore
7.70
自引率
8.80%
发文量
144
审稿时长
6-12 weeks
期刊介绍: Maternal & Child Nutrition addresses fundamental aspects of nutrition and its outcomes in women and their children, both in early and later life, and keeps its audience fully informed about new initiatives, the latest research findings and innovative ways of responding to changes in public attitudes and policy. Drawing from global sources, the Journal provides an invaluable source of up to date information for health professionals, academics and service users with interests in maternal and child nutrition. Its scope includes pre-conception, antenatal and postnatal maternal nutrition, women''s nutrition throughout their reproductive years, and fetal, neonatal, infant, child and adolescent nutrition and their effects throughout life.
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