Acceptability of Antenatal Multiple Micronutrient Supplementation (MMS) Compared to Iron and Folic Acid (IFA) Supplementation in Pregnant Individuals: A Narrative Review.
Mihaela C Kissell, Carolina Pereira, Filomena Gomes, Kidist Woldesenbet, Masresha Tessema, Hiwot Kelemu, Ramadhani Noor, Luz Escubil, Aishwarya Panicker, Ashutosh Mishra, Mai-Anh Hoang, Hou Kroeun, Cassandra Sauer, Meng Sokchea, Crystal D Karakochuk, Masako Horino, Keith P West, Akihiro Seita, Djeinam Toure, Umu H Jalloh, Francis Moses, Aminata S Koroma, Bakary Diarra, Ousmane Camara, Ouassa Sanogo, Kristine Garn, Martin N Mwangi
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引用次数: 0
Abstract
Background/Objectives: Antenatal multiple micronutrient supplementation (MMS) improves birth outcomes more effectively than iron and folic acid (IFA) supplementation alone. However, the acceptability of MMS among pregnant individuals, a critical factor for adherence and program success, remains poorly defined and inconsistently assessed. This narrative review proposes a comprehensive definition of "acceptability" in the context of nutritional supplementation and evaluates the evidence on the acceptability of MMS compared to IFA in low- and middle-income countries (LMICs). Methods: We conducted a systematic literature search across Embase, Medline, and Scopus to identify studies (including grey literature) reporting on acceptability-related outcomes for MMS versus IFA among pregnant individuals. Studies exploring dimensions such as organoleptic properties, ease of consumption, side effects, cultural appropriateness, and socioeconomic factors were included. Results: Out of 1056 screened studies, five informed a novel multi-dimensional definition of acceptability. Six studies assessed acceptability-related characteristics. MMS was generally accepted across most organoleptic domains. Most studies reported fewer or comparable adverse side effects for MMS as compared to IFA. Studies consistently reported more perceived benefits for MMS than IFA. Facilitating factors included trust in health professionals, free provision, and family support. Barriers included poor taste or smell, fear of side effects, misconceptions, cost, and lack of family support. Conclusions: Antenatal MMS is widely acceptable in LMICs. Addressing socio-cultural, sensory, and socioeconomic factors is essential to increase uptake and adherence. This review provides a clear, standardized definition of acceptability to guide future research and inform effective program design.
期刊介绍:
Nutrients (ISSN 2072-6643) is an international, peer-reviewed open access advanced forum for studies related to Human Nutrition. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.