Maternal and Child Nutrition最新文献

{"title":"Quantification of persistent organic pollutants in breastmilk and estimated infant intake, Norway","authors":"Kristina R. Nermo,&nbsp;Jan L. Lyche,&nbsp;Gabrielle Haddad-Weiser,&nbsp;Tonje E. Aarsland,&nbsp;Siri Kaldenbach,&nbsp;Beate Solvik,&nbsp;Anuschka Polder,&nbsp;Tor A. Strand,&nbsp;Kjersti S. Bakken","doi":"10.1111/mcn.13759","DOIUrl":"10.1111/mcn.13759","url":null,"abstract":"<p>Persistent organic pollutants (POPs) are environmental contaminants that can accumulate in human tissues and pose potential health risks. Despite global efforts to reduce their prevalence, follow-up studies are needed to see if the measures are successful. Since most infants in Norway are breastfed for the first 6 months of life, monitoring POP contamination in breastmilk is important for children's health and development. This study aims to evaluate the current levels of various POPs in women's breastmilk in Innlandet County, Norway. A cross-sectional study was conducted measuring concentrations of 35 different POPs, including polychlorinated biphenyls (PCBs), chlordanes (ChlDs), hexachlorocyclohexanes (HCHs), dichlorodiphenyltrichloroethanes (DDTs), Mirex, and brominated flame retardants in 120 breastmilk samples. The study analysed the impact of maternal age, parity, pre-pregnancy BMI, and infant age on POPs levels and compared the estimated daily intake per body weight of infants to existing health guidelines. The detected percentages for PCBs were 100%, for DDTs 98.3%, and for ChlDs 98.3%. The highest median concentration was found for ΣPCBs (26.9 ng/g lw). Maternal age, parity, and infant age were significant determinants of POP concentrations. Most infants exceeded the health-based guidance values for ΣPCB, and 6.4% percent did so for ΣHCHs. Despite lower POPs concentrations in breastmilk than in earlier studies, many breastfed infants are still exposed to levels exceeding health-based guidance values. Although the study's design had limitations, the study provides updated population-based data on POPs in breastmilk. Continued monitoring and research are necessary to understand and mitigate potential health risks associated with POPs.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canned complementary porridges for infants and young children (6–23 months) based on African indigenous crops; nutritional content, consistency, sensory, and affordability compared to traditional porridges based on maize and finger millet","authors":"Trond Løvdal,&nbsp;Josefine Skaret,&nbsp;Gorana Drobac,&nbsp;Blessed Okole,&nbsp;Izumi Sone,&nbsp;Natalia Rosa-Sibakov,&nbsp;Paula Varela","doi":"10.1111/mcn.13752","DOIUrl":"10.1111/mcn.13752","url":null,"abstract":"<p>Child malnutrition is a major health problem in Sub-Saharan Africa. Complementary foods made from African indigenous and locally available raw materials are often low in protein and nutrients. It is, therefore, important to supply complementary foods that are nutritious and affordable, and with an acceptable consistency and taste. The objective of this study was to develop, on a pilot scale, food-to-food fortified, convenient, canned complementary porridges based on blends of African indigenous crops, i.e., orange fleshed sweet potato (OFSP) flour, and leguminous (i.e., cowpea, and Bambara groundnut) and cereal flours (i.e., teff, finger millet, maize, and amaranth), and milk powder. Plant-based, African complementary foods are often lacking in vitamin A, zinc, iron, and energy. Porridge with OFSP on a 32% dry weight (dw) basis achieved recommended levels of vitamin A (530 µg per 100 g dw). Satisfactory energy (431 Kcal per 100 g dw) was obtained by supplementation of vegetable oil. A nutritious, low-cost porridge (costing 0.15 € per 100 g can) that fulfills consistency constraints was obtained by including supplements of zinc and iron salts as ingredients. The solids content and thus protein/energy could be significantly increased using protein fractionated or germinated cowpea flours without compromising on viscosity. The sensory profile was characterised by more intense vegetable, leguminous, and malty flavours as compared to traditional reference porridges.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's dietary diversity is associated with homestead production and market access: A cross-sectional study in rural Rwanda","authors":"Theogene Dusingizimana,&nbsp;Gilbert Nduwayezu,&nbsp;Tomas Kjelqvist","doi":"10.1111/mcn.13755","DOIUrl":"10.1111/mcn.13755","url":null,"abstract":"<p>Dietary diversity has been widely used as a proxy indicator for micronutrient adequacy. In low- and middle-income countries (LMICs), including Rwanda, women are at high risk of inadequate micronutrient intake resulting from poorly diversified diets. This study was conducted to examine the factors associated with women's dietary diversity, with emphasis on homestead production diversity and market access in the Northern Province of Rwanda. A cross-sectional design was used, involving 606 women aged 18–49 years. Linear regression analyses were performed to examine the association between various factors and women's dietary diversity. Results show that 84% of the sample households raised at least one livestock species. Seventy-one percent of the households had no agricultural land. Eighty percent of those without land had a homestead garden on which they grew food crops, mainly vegetables and fruit trees. The average crop species was 2.3. On average, women consumed 3 out of 9 food groups. The homestead production diversity score was positively associated with women's dietary diversity score (<i>β</i> = 0.16, <i>p</i> &lt; 0.001). Women's dietary diversity score was negatively associated with distance from the household to the nearest market (<i>β</i> = −0.08, <i>p</i> = 0.027) and household food insecurity (<i>β</i> = −0.06, <i>p</i> &lt; 0.001). Maternal education (<i>p</i> &lt; 0.001), household wealth index (<i>p</i> &lt; 0.05), and ownership of more than 2.5 acres compared to being without land (<i>p</i> &lt; 0.05) were associated with women's dietary diversity score. The dietary diversity of women could be enhanced through interventions that promote the diversity of livestock and crop species produced through homestead production. Potential interventions to explore may include integrated farming systems that combine small livestock and crop production utilising improved livestock breeds and high-quality seeds and planting materials of high-yielding varieties of fruits and vegetables, along with rainwater harvesting to facilitate small-scale irrigation. The impact of such interventions on women's dietary diversity can be further reinforced by parallel programmes aimed at improving women's education and the socioeconomic status of households.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13755","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Global Health Systems to Protect, Promote and Support Optimal Breastfeeding","authors":"David T. Zhu,&nbsp;Tarini Gupta,&nbsp;Rafael Pérez-Escamilla","doi":"10.1111/mcn.13753","DOIUrl":"10.1111/mcn.13753","url":null,"abstract":"<p>Breastfeeding is a critical public health strategy for optimal child development and maternal health across the life course. The 2021 Global Burden of Diseases, Injuries and Risk Factors Study reveals that, despite reductions in mortality and disability-adjusted life years (DALYs) attributed to suboptimal breastfeeding practices—namely, non-exclusive breastfeeding during the first 6 months or early discontinuation within the first 2 years—low- and middle-income countries (LMICs) continue to bear a staggering 50-fold higher burden compared to high-income nations. This inequity signals a pressing global health priority. Hence, we propose to address these challenges by first, expanding the Baby-Friendly Hospital Initiative (BFHI) reach through community-driven efforts such as the Baby-Friendly Community Initiative (BFCI) to enhance breastfeeding support in both clinical and community settings; second, embedding breastfeeding counselling within national health and social protection programmes to fill in gaps in culturally competent care, drawing on large scale breastfeeding peer counselling programme experiences like the one being implemented by the US Supplemental Nutrition Program for Women, Infants and Children (WIC); third, improving maternity leave policies and workplace accommodations for breastfeeding women and fourth, stringent regulation of exploitative commercial milk formula (CMF) marketing to combat misinformation and reduce health inequities. Governments must implement strong, evidence-driven policies—such as strict monitoring and regulation of product labelling and digital media marketing—to establish safeguards against the powerful influence of the CMF industry. Collectively, these strategies will enhance breastfeeding outcomes, reduce health disparities and drive progress across countries towards meeting the UN Sustainable Development Goals.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the complex dynamics influencing acute malnutrition in Turkana and Samburu counties: Study protocol.","authors":"Calistus Wilunda, Estelle Sidze, Faith Thuita, Dickson Amugsi, Amanuel Abajobir, Martin Mutua, Bonventure Mwangi, Samuel Iddi, Chessa Lutter, Valerie L Flax, Albert Webale, Esther Anono, Hazel Odhiambo, Caroline Wangui Wainaina, Stephen Ekiru, Gillian Chepkwony, John Ebei, Duncan Lesiamito, Elizabeth Kimani-Murage, Brad Sagara","doi":"10.1111/mcn.13744","DOIUrl":"https://doi.org/10.1111/mcn.13744","url":null,"abstract":"<p><p>Acute malnutrition in children under 5 years is persistent in Eastern Africa's arid and semiarid lands. This study aimed to identify the drivers of acute malnutrition in Turkana and Samburu counties, Kenya. This was a population-based longitudinal mixed-methods observational study. Qualitative and quantitative data were collected at Wave 1, but only quantitative data were collected during follow-up. Participants were a representative sample of children and their primary caregivers from households with children under 3 years at Wave 1. Anthropometric measurements of all children under 5 years in the sampled households were taken at Wave 1 (May to July 2021), and one child under 3 years was randomly selected for follow-up about every 4 months over 2 years for six data collection waves. The study also collected data on sociodemographics; child feeding practices and morbidity; household water and food insecurity; shocks; coping strategies, social safety nets and economic safeguards; water, sanitation and hygiene; women's decision-making and food consumption. Qualitative data were collected through community dialogues, focus group discussions, in-depth interviews, photovoice and key informant interviews with mothers and fathers with children under 5 years, community leaders, county officials and staff of nongovernmental organisations. Data collection is complete and analysis is ongoing. The analysis includes thematic analysis of qualitative data and descriptive and multi-variable regression analyses of quantitative data.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e13744"},"PeriodicalIF":2.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enteral micronutrient supplementation and neurodevelopmental outcomes in preterm or low birth weight infants: A systematic review and meta-analysis","authors":"Yakun Liu,&nbsp;Shaobin Jin,&nbsp;Guoqing Zhang,&nbsp;Tingwei Chen,&nbsp;Shungen Huang","doi":"10.1111/mcn.13756","DOIUrl":"10.1111/mcn.13756","url":null,"abstract":"<p>The association of enteral micronutrient supplementation and the neurodevelopmental outcomes of preterm or low birth weight (LBW) infants is controversial. This research was prospectively registered (CRD42023454034). We searched MEDLINE, Embase, PsycInfo, ClinicalTrials. gov, and the Cochrane Library for randomised clinical trials (RCTs) or quasi-RCTs comparing any enteral micronutrients supplementation with placebo or no supplementation in preterm or LBW infants. The primary outcome was neurodevelopmental impairment (NDI), with secondary outcomes involving various neurodevelopmental tests and disabilities. There was no evidence of an association between enteral micronutrients supplementation and the risk of NDI (RR, 1.03; 95% CI, 0.93–1.14; moderate certainty evidence). There was no evidence that the supplemented groups enhanced cognitive (MD, 0.65; 95% CI, −0.37 to 1.67; low certainty evidence), language (SMD, −0.01; 95% CI, −0.11 to 0.09; moderate certainty evidence), or motor scores (SMD, 0.04; 95% CI, −0.06 to 0.15; very low certainty evidence) or IQ (SMD, −0.20; 95% CI, −0.53 to 0.13; very low certainty evidence). Subgroup analysis showed that multiple micronutrients supplementation improved expressive language score (MD, 1.42; 95% CI, 0.39–2.45), and zinc supplementation enhanced fine motor score (SMD, 1.70; 95% CI, 0.98–2.43). The overall heterogeneity was low. This study demonstrates that enteral micronutrient supplementation is associated with little or no benefits in neurodevelopmental outcomes for preterm or LBW infants. Well-designed RCTs are needed to further ascertain these associations.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13756","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wasting coexisting with underweight and stunting among children aged 6‒59 months hospitalised in Garissa County Referral Hospital, Kenya","authors":"Mutuvi Wambua,&nbsp;Symon M. Kariuki,&nbsp;Hassan Abdullahi,&nbsp;Osman A. Abdullahi,&nbsp;Moses M. Ngari","doi":"10.1111/mcn.13754","DOIUrl":"10.1111/mcn.13754","url":null,"abstract":"<p>Management of undernourished children depends only on wasting yet it can coexist with underweight and/or stunting. Among children admitted to hospital with acute illness, we determined the proportion with wasting coexisting with underweight and/or stunting and their risk factors. A retrospective review of hospital records of children 6‒59 months old admitted at Garissa County referral hospital, Kenya, from January 2017 to December 2019 was conducted. Using World Health Organization 2006 growth standards, undernutrition were defined: wasting as Weight-for-height Z-score &lt; −2, stunting Height-for-age Z-score &lt; −2 and underweight Weight-for-age Z-score &lt; −2. We studied wasting coexisting with underweight and/or stunting. Among 624 children recruited, 347 (56%) were males and 511 (82%) &lt;24 months old. Diarrhoea 210 (34%) and pallor/anaemia 310 (50%) were the most frequent admission diagnosis. HIV infection was present among 8 (1.3%) children. Wasting, underweight and stunting were present among 595 (95%), 518 (83%) and 176 (28%) children respectively. 161 (26%), 506 (81%) and 161 (26%) children had wasting coexisting with stunting, underweight and both stunting and underweight respectively. In the multivariable regression, diarrhoea was positively associated with wasting coexisting with stunting (adjusted risk ratio [aRR = 2.96] [95% CI = 2.06‒4.23]) and anaemia with wasting coexisting with underweight (aRR = 1.23) (95% CI = 1.03‒1.47). Overall, 343 (55%) children were discharged alive, 67 (11%) absconded from the wards, 164 (26%) were transferred to another hospital and 50 (8.0%) died before discharge. The risk of inpatient death was 10.3%, 7.9%, 8.4% and 6.8% among children not wasted, wasted only, wasted &amp; underweight, and wasted and underweight and stunted respectively (Chi-square <i>p</i> = 0.60). The study reports an unacceptably high levels of undernourishment, including coexisting forms of undernutrition among hospitalised children. This highlights a public health priority for current nutrition therapeutic care and need of continuity of care among those children discharged alive in the community-based management of acute malnutrition programmes.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food purchase diversity is associated with market food diversity and diets of children and their mothers but not fathers in rural Tanzania: Results from the EFFECTS baseline survey","authors":"Savannah F. O'Malley,&nbsp;Ramya Ambikapathi,&nbsp;Morgan Boncyk,&nbsp;Dominic Mosha,&nbsp;Cristiana K. Verissimo,&nbsp;Lauren Galvin,&nbsp;Frank Mapendo,&nbsp;Isaac Lyatuu,&nbsp;Mary Pat Kieffer,&nbsp;Joshua Jeong,&nbsp;Evidence Matangi,&nbsp;George PrayGod,&nbsp;Nilupa S. Gunaratna","doi":"10.1111/mcn.13734","DOIUrl":"10.1111/mcn.13734","url":null,"abstract":"<p>Rural households in East Africa rely on local markets, but the influence of market food diversity and household food purchase diversity on diets has not been well-characterized. We quantify the associations among market food diversity, household food purchase diversity and dietary diversity of mothers, fathers and children in rural Tanzania. This study uses baseline data from a randomized controlled trial, Engaging Fathers for Effective Child Nutrition and Development in Tanzania. We used the 10 food groups for women's dietary diversity to assess the seasonal availability of nutritious foods in 79 markets. Using data from 957 rural households in two districts in Mara, Tanzania, we measured household food purchase diversity over the previous month and dietary diversity among children (6–23 months), mothers and fathers. Overall, 63% of markets sold all 10 food groups throughout the year, indicating high-market food diversity and minimal seasonality. However, only 33% of women and 35% of children met dietary diversity recommendations. Households that reported higher purchasing power (0.14, <i>p</i> &lt; 0.001), lived within 30 min of a market (0.36, <i>p</i> = 0.001) and had access to a highly diverse market (0.37, <i>p</i> = 0.01) purchased a higher diversity of foods. In turn, food purchase diversity was positively associated with the dietary diversity of mothers (<i>p</i> &lt; 0.001) and children 9–23 months (<i>p</i> &lt; 0.001) but not fathers (<i>p</i> = 0.56). Interventions must account for food availability and access in local markets, and promoting diverse food purchases may be an effective strategy to improve women's and children's diets in rural areas.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13734","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary diversity and nutrient adequacy among women in Bosomtwe District, Ghana","authors":"Charles Apprey,&nbsp;Hammond Yaw Addae,&nbsp;Grace Boateng,&nbsp;Linda Esi Aduku,&nbsp;Reginald Adjetey Annan","doi":"10.1111/mcn.13757","DOIUrl":"10.1111/mcn.13757","url":null,"abstract":"<p>The sustainable development goals seek to end all forms of malnutrition of women of reproductive age (WRA) by 2030. As such, recent data on nutrient adequacy are needed to aid in tracking progress. However, data on specific dietary nutrient intakes includes only iron, folate, vitamin A, and vitamin B₁₂ in Ghana. Therefore, women's dietary diversity score (W-DDS) is often used as a proxy measure of nutrient adequacy. It is hypothesised that there is no association between W-DDS and Nutrient Adequacy among WRA in peri-urban Ghana. Hence, this research evaluated the associations between W-DDS and nutrient adequacy ratio (NAR) and assessed the determinants of mean nutrient adequacy ratio (MAR) in the Bosomtwe District of Ghana. A community-based cross-sectional study was conducted, and data collected on anthropometry, food insecurity, socio-demographic characteristics and dietary intake using the 24-hour recall from 407 WRA. In all, 21 nutrients were assessed. The mean age, W-DDS, and MAR were 29.0 ± 6.7 years, 5.3 ± 1.9, and 0.65 ± 0.19 respectively. The NAR were generally high for the macronutrients as compared to micronutrients and the nutrients with low NAR included vitamin C (0.27 ± 0.19), vitamin A (0.15 ± 0.23), vitamin B₁₂ (0.54 ± 0.32), calcium (0.28 ± 0.20), zinc (0.52 ± 0.23) and iron (0.57 ± 0.28) - signifying the WRA may be consuming monotonous carbohydrate-based diet. The hierarchical multivariable linear regression found a significant association between W-DDS and MAR after controlling for confounders (<i>β</i> = 0.404, <i>p</i> &lt; 0.001). The determinants of MAR were ethnicity (<i>β</i> = 0.110, <i>p</i> = 0.006) and body mass index (β = 0.189, <i>p</i> &lt; 0.001). This study supports the use of W-DDS as a proxy indicator of nutrient adequacy. Strategies meant to address nutrient inadequacies should be adaptable to different ethnic groups and overweight-reducing strategies should be incorporated into broader nutrition initiatives.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring factors affecting adherence to multiple micronutrient supplementation during pregnancy in Cambodia: A qualitative analysis","authors":"Jocelyne M. Labonté,&nbsp;Mai-Anh Hoang,&nbsp;Aishwarya Panicker,&nbsp;Hou Kroeun,&nbsp;Meng Sokchea,&nbsp;Sreang Sambo,&nbsp;Vin Sokhal,&nbsp;Cassandra Sauer,&nbsp;Mary Chea,&nbsp;Crystal D. Karakochuk","doi":"10.1111/mcn.13745","DOIUrl":"10.1111/mcn.13745","url":null,"abstract":"<p>For decades, iron-folic acid (IFA) supplements have been provided to pregnant women in Cambodia through antenatal care (ANC) services. However, mounting evidence suggests that multiple micronutrient supplements (MMS) are superior to IFA supplements in achieving positive pregnancy outcomes. The possibility of transitioning from IFA supplements to MMS in government-run health centres is currently being assessed in Cambodia. A crucial component of this assessment involves identifying factors that can influence adherence to MMS, as low adherence can reduce supplement effectiveness. Consequently, this study aimed to explore the potential barriers and enablers to MMS adherence and identify the strengths and challenges of current ANC services. Data were collected through nine focus group discussions with pregnant women (<i>n</i> = 19), family members (<i>n</i> = 18) and midwives (<i>n</i> = 18) and three in-depth interviews with maternal and child health chiefs (<i>n</i> = 3) in Cambodia and analysed via content analysis. Factors found to influence MMS adherence included attitudes, perceptions and beliefs about MMS; knowledge related to supplementation; ANC counselling; family influence; physical health; access to ANC; supply of MMS; and supplementation norms. Noted strengths of ANC services were the quality of ANC materials, tailored patient education, midwife–patient relationships and flexibility of provided services. Primary challenges related to poor availability of ANC materials, inadequate midwife training, heavy workload, limited funding and suboptimal physical spaces for delivering ANC services. To effectively promote MMS adherence, strategies must involve pregnant women, family members and community leaders; seek to address knowledge gaps and misconceptions related to MMS; and enhance the availability and accessibility of ANC services.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13745","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}