Maternal and Child Nutrition最新文献

{"title":"Barriers and facilitators to healthy eating during post-partum among non-Hispanic Black mothers","authors":"Melissa C. Kay,&nbsp;Margaret Bentley,&nbsp;Heather Wasser","doi":"10.1111/mcn.13741","DOIUrl":"10.1111/mcn.13741","url":null,"abstract":"<p>Maternal diet is a key predictor of child diet, yet an in-depth inquiry into the barriers and facilitators for the adoption of healthy eating behaviours during the post-partum period is lacking, specifically for non-Hispanic Black mothers. This study used qualitative research methods to investigate healthy eating practices among a sample of non-Hispanic Black mothers participating in a family-based obesity prevention intervention. In-depth interviews were conducted with 22 mothers who participated in the <i>Mothers and Others: Family-based Obesity Prevention for Infants and Toddlers</i> intervention trial. Interviews were audio-recorded and transcribed verbatim. A deductive and inductive process was used to develop a consensus codebook; once the data were coded, matrices were developed to explore the data and identify similarities and differences between respondents. Relevant themes were identified, and salient quotes were used to illustrate each theme. Mothers believed that time and taste were significant barriers to eating healthy. Social influence and social support had both positive and negative influences on mothers' ability to adopt healthy eating behaviours. Despite their children often being a facilitator to healthy eating, many mothers struggled with finding the time, energy and desire to focus on themselves when it came to healthy eating. Many mothers were intent on preparing healthy meals and snacks for their children but did not prepare them for themselves. Future interventions should focus on the importance of role-modelling healthy eating behaviours for their children and include behaviour change strategies that incorporate skill-building activities emphasizing time-saving methods for planning and preparing healthy meals and snacks for the whole family to eat.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401895","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":"The impact of web-based education provided to parents on the nutritional risk of preschoolers: A quasi-experimental study","authors":"Merve Azak,&nbsp;Duygu Gözen","doi":"10.1111/mcn.13735","DOIUrl":"10.1111/mcn.13735","url":null,"abstract":"<p>The purpose of this study was to evaluate the effectiveness of web-based nutrition education for parents of preschool children in reducing nutritional risk. The study was conducted in a one-group pretest–posttest quasi-experimental design. Parents of 3–5-year-old children from 11 preschools in Istanbul participated. They underwent a web-based nutrition education program. The NutriSTEP assessment tool was used to evaluate the nutritional risk score as a pretest assessment, followed by the training program. Posttests were conducted at 1- and 3-month intervals. Before the intervention, 55.8% of the children exhibited high nutritional risk. After the intervention, this percentage decreased significantly at the 1-month and 3-month follow-ups, with 94.2% and 93.6% of the children classified as low risk, respectively. The analysis also revealed significant associations between children's eating behaviours and factors such as maternal education, family income and family structure. As a result, web-based nutrition education was effective in reducing nutritional risk among preschool children. The findings underscore the importance of using technology for nutrition interventions, especially in diverse populations. The training program's simple, short and understandable video increased participants' interest in the training and encouraged regular follow-up.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13735","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480110","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":"A qualitative exploration of the COVID-19 pandemic on health and nutrition behaviours during the first 1000 days in Sri Lanka","authors":"Teresa R. Schwendler,&nbsp;Upul Senarath,&nbsp;Hiranya Jayawickrama,&nbsp;Dhammica Rowel,&nbsp;Noor Kawmi,&nbsp;Safina Abdulloeva,&nbsp;Chithramalee De Silva,&nbsp;Stephen R. Kodish","doi":"10.1111/mcn.13731","DOIUrl":"10.1111/mcn.13731","url":null,"abstract":"<p>This study sought to understand reported impacts of the COVID-19 pandemic on maternal and child health and nutrition behaviours during the first 1000 days of life. This qualitative and participatory substudy was embedded within mixed methods formative research conducted during 2020–2022 across two urban, three rural and one estate sector site in Sri Lanka. Semi-structured interviews among caregivers of children aged 6–23 months (<i>n</i> = 34), influencers of caregivers, such as health workers (<i>n</i> = 37), leaders (<i>n</i> = 10) and pregnant women (<i>n</i> = 20) were conducted. Participatory workshops (<i>n</i> = 14) triangulated interview findings. Interview data were analyzed to identify salient themes using Dedoose. Numerical data from voting conducted in workshops were summed and triangulated with interview data. Findings suggest that the COVID-19 pandemic and imposed restrictions shaped maternal and child health and nutrition behaviours through a complex interplay of factors. Imposed restrictions and changes to the food system contributed to temporary unemployment for wage workers and reduced purchasing power to maintain food security for vulnerable households. While deciding whether to seek care, fears of infection prevented usual care-seeking decisions. Also, reduced incomes and disrupted public transportation made transport to health care facilities for antenatal care services difficult. Once women reached facilities, medical services and quality of care were negatively impacted. Implementing expanded community-based services during home visits focused on the first 1000 days and beyond was one effective strategy to maintain maternal and child health and nutrition during the early pandemic in Sri Lanka.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395046","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":"Prevalence and determinants of stunting and anaemia in children aged 6–23 months: A multilevel analysis from rural Ethiopia","authors":"Habtamu Guja,&nbsp;Mariana Belgiu,&nbsp;Kaleab Baye,&nbsp;Alfred Stein","doi":"10.1111/mcn.13736","DOIUrl":"10.1111/mcn.13736","url":null,"abstract":"<p>Low- and middle-income countries shoulder the greatest burden of stunting and anaemia in children. This calls for prompt and effective intervention measures, while the contributing factors are not fully understood. This study evaluates determinants spanning from individual-, household- and community levels including agroecology and antinutrients as unique sets of predictors. Primary data were collected from 660 rural households representing the midland (ML), highland, and upper highland (UHL) agroecological zones from northern Ethiopia. The study relates several predictors to stunting and anaemia in children aged 6–23 months. We found 49.1% and 49.7% of children were stunted and anaemic, respectively. Children living in the ML are approximately twice more likely to be stunted adjusted odds ratio (AOR: 1.869; 95% CI: 1.147–3.043) than in the UHL. The risk of stunting increases by 16.3% and 41.9% for every unit increase in phytate-to-zinc and phytate-to-iron molar ratios, respectively. A 10% increase in mean aggregated crop yield was observed to reduce the likelihood of stunting occurrence by 13.6%. Households lacking non-farm income-generating opportunities, travel longer time to access the marketplace and poor health service utilisation were associated with increased risk of stunting. Low diversity of child's diet, age of the child (18–23 months) and mothers at a younger age are significantly associated with stunting. Risk of anaemia in children is high amongst households with unimproved water, sanitation, and hygiene practices, younger age (6–11 months) and mostly occurs amongst boys. Children in the ML had a 55% reduced risk of being anaemic (AOR: 0.446; 95% CI: 0.273–0.728) as compared to the UHL. Therefore, the influence of these factors should be considered to tailor strategies for reducing undernutrition in children of 6–23 months in rural Ethiopia. Interventions should go beyond the administrative boundaries into targeting agroecological variation.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13736","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395047","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":"Strengthening nutrition policy and service delivery: Lessons learned from a six-country assessment of Alive and Thrive's technical assistance.","authors":"Kendra Siekmans, Sujata Bose, Jessica Escobar-DeMarco, Edward A Frongillo","doi":"10.1111/mcn.13711","DOIUrl":"https://doi.org/10.1111/mcn.13711","url":null,"abstract":"<p><p>Alive & Thrive (A&T) provides strategic technical assistance (TA) to develop effective policies; improve maternal, infant, and young child nutrition (MIYCN) programme design and implementation and enhance system capacity to sustain quality MIYCN service delivery at scale. A qualitative assessment was conducted using document review and stakeholder interviews (n = 79) to describe a selection of A&T's TA in six countries and systematically assess the contextual and TA process-related factors that influenced the results achieved and document the lessons learned about MIYCN TA design and implementation. To facilitate the selection of different types of TA, we classified TA into two levels of stakeholder engagement and intensity. Under the Technical Advisor TA category, we assessed A&T's support to strengthen national policy formulation, monitoring, and implementation of the International Code of Marketing of Breast-milk Substitutes. For Capacity Development TA, we assessed A&T support to scale-up maternal nutrition services and to increase strategic use of data. Factors important for TA provision included identifying and engaging with the right people, using evidence to support advocacy and decision-making, using multiple ways to strengthen capacity, developing packages of tools to support programme scale-up, and reinforcing feedback mechanisms to improve service provision and data quality. Challenges included shifts in the political context, poorly functioning health systems, and limited resources to replicate or sustain the progress made. Continued investment in evidence-based and practical TA that strengthens the institutionalization of nutrition across all stakeholders-including government, medical associations, civil society and development partners-is essential. Future TA must support governments to strengthen system capacity for nutrition, including financial and human resource gaps that hamper full scale-up.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e13711"},"PeriodicalIF":2.8,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373529","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":"Use of multiple micronutrient supplementation integrated into routine antenatal care: A discussion of research priorities","authors":"Tabassum Firoz,&nbsp;Jahnavi Daru,&nbsp;Jennifer Busch-Hallen,&nbsp;Özge Tunçalp,&nbsp;Lisa M. Rogers","doi":"10.1111/mcn.13722","DOIUrl":"10.1111/mcn.13722","url":null,"abstract":"<p>Optimal maternal nutrition, including adequate intake and status of essential micronutrients, is important for the health of women and developing infants. Currently, the World Health Organization (WHO) <i>Antenatal care recommendations for a positive pregnancy experience</i> recommend daily iron and folic acid (IFA) supplementation as the standard of care. The use of multiple micronutrient supplements (MMS) is recommended in the context of rigorous research as more evidence was needed regarding the impact of switching from IFA supplements to MMS, including evaluation of critical clinical maternal and perinatal outcomes, acceptability, feasibility, sustainability, equity and cost-effectiveness. WHO convened a technical consultation of key stakeholders to discuss research priorities with the objective of providing guidance and clarity to donors, implementers and researchers about this recommendation. The overarching principles of the research agenda include the use of clinical indicators and impact measures that are applicable across studies and settings and the inclusion of outcomes that are important to women. Future studies should consider using standardized protocols based on current best practices to measure critical outcomes such as gestational age (GA) and birthweight (BW) in studies. As GA and BW are influenced by multiple factors, more research is needed to understand the biological impact pathways, and how initiation and considerations for timing of MMS influence these outcomes. A set of core clinical indicators was agreed upon during the technical consultation. For implementation research, the Evidence-to-Decision framework was used as a resource for discussing components of implementation research. The implementation research questions, key indicators and performance measures will depend on country-specific context and bottlenecks that require further research and improved solutions to enable the successful implementation of iron-containing supplements.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13722","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362404","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":"Association between low-calorie sweetener consumption during pregnancy and child health: A systematic review and meta-analysis","authors":"Bereket Gebremichael,&nbsp;Zohra S. Lassi,&nbsp;Mumtaz Begum,&nbsp;Shao Jia Zhou","doi":"10.1111/mcn.13737","DOIUrl":"10.1111/mcn.13737","url":null,"abstract":"<p>We examined the association between low-calorie sweeteners (LCS) consumption during preconception, pregnancy, and breastfeeding and child health outcomes. A systematic search of electronic databases in PubMed, Embase, Cumulated Index to Nursing and Allied Health Literature, the Cochrane Library, Scopus, Web of Science, PsycINFO, ProQuest Health and Medical, ClinicalTrials.gov, and Google Scholar was conducted up to 21 September 2023. A random effects model with restricted maximum likelihood estimation was used for the meta-analysis. Seventeen eligible studies were included. The standardised mean difference (SMD) and 95% confidence interval (CI) in birth weight between those who frequently consumed LCS (≥1 serve/day) during pregnancy and those who did not consume LCS was 0.04 (0.00, 0.08) (four cohort studies). Any LCS consumption during pregnancy compared with no consumption was not associated with birth weight [SMD (95% CI) = 0.03 (−0.03, 0.08)] (four cohort studies). Any LCS consumption during pregnancy was not associated with body mass index z-scores. The weighted mean difference (95% CI) was 0.00 (−0.05, 0.06) at birth, 0.06 (−0.29, 0.40) at 6 months, −0.04 (−0.19, 0.10) at 1 year, 0.00 (−0.16, 0.17) at 3 years, and 0.10 (−0.15, 0.34) at 7 years of the child age, compared with no intake (five cohort studies). The odds of being overweight at 1 year among children exposed to LCS during pregnancy was 1.19 (OR [95% CI]: 1.19 [0.81, 1.58]) compared with unexposed children (two cohort studies). The effect sizes were not precise for all the outcomes as the 95% CI indicated the effect estimates could range from small protective to a higher risk. The effect of LCS consumption on child behaviour and cognition was inconsistent. There is not enough evidence to confirm LCS consumption during pregnancy affects birth weight and risk of overweight in children. However, frequent consumption increased birth weight and the risk of overweight at different ages, though the effects were imprecise. More robust research evidence is required as the quality of evidence is low.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331928","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":"A landscape analysis of investors in the global breast milk substitute industry to target for advocacy","authors":"Benjamin Wood,&nbsp;Ella Robinson,&nbsp;David McCoy,&nbsp;Phillip Baker,&nbsp;Gary Sacks","doi":"10.1111/mcn.13721","DOIUrl":"10.1111/mcn.13721","url":null,"abstract":"<p>The International Code of Marketing of Breast-milk Substitutes and subsequent resolutions (the Code) was adopted to address increases in mortality and morbidity resulting from the practices of the breast-milk substitute (BMS) industry. The lack of success in ensuring company compliance with the Code has prompted advocates to consider engaging with investors to shape the governance of BMS companies. To support these efforts, this paper aimed to identify prominent investors in the global BMS industry and explore their Code-related policies and practices. Using multiple methods and data sources, we developed a novel approach to identify and rank investors in the world's leading publicly listed BMS companies. We also examined the policies and voting behaviour of a sample of investors using publicly accessible materials from 2020 to 2022. We found that a small number of large investors, led by BlackRock and Vanguard, hold a substantial share in the global BMS industry. Of the top-10 ranked investors, only Norway's Government Pension Fund (NBIM) reported policy information relating specifically to BMS marketing. Most of these large investors also opposed the sample of public health-related shareholder proposals analysed. In addition, we identified several investors that have reported engaging with BMS companies on Code-related issues, including NBIM, Pictet, and UBS, along with several potential investor targets for future advocacy efforts, including some North American public pension funds. The inclusion of Code-related issues as part of broader policies, disclosures and regulations related to environmental, social and governance oriented investment warrants increased attention.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331927","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":"Using formative research to enhance our understanding of implementation contexts: Preparing for a trial of maternal nutrition interventions","authors":"Andrew L. Thorne-Lyman,&nbsp;Anna Kalbarczyk,&nbsp;Alison Tumilowicz,&nbsp;Parul Christian,&nbsp;Kaosar Afsana","doi":"10.1111/mcn.13639","DOIUrl":"10.1111/mcn.13639","url":null,"abstract":"&lt;p&gt;Traditionally, nutrition interventions during pregnancy in low- and middle-income countries (LMICs) have received less attention than interventions focused on child nutrition. However, a solid body of evidence suggests that interventions to address micronutrient and macronutrient deficiencies during pregnancy could significantly improve both maternal and neonatal health along with foetal and child growth (Koivu et al., &lt;span&gt;2023&lt;/span&gt;; World Health Organization [WHO], &lt;span&gt;2016&lt;/span&gt;; Zavala et al., &lt;span&gt;2022&lt;/span&gt;) and need to be delivered at scale.&lt;/p&gt;&lt;p&gt;The WHO guidelines for a healthy pregnancy include several evidence-based nutrition interventions. Along with iron-folic acid (IFA), calcium and dietary education, the guidelines currently recommend multiple micronutrient supplementation (MMS) as a replacement for IFA ‘in the context of rigorous research’ and balanced energy and protein (BEP) supplementation specifically for contexts of high undernutrition (WHO, &lt;span&gt;2016&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;The importance of finding ways to optimise the delivery of nutrition interventions to pregnant women has been highlighted in many recent reviews including the Lancet Series on Maternal and Child Nutrition (Heidkamp et al., &lt;span&gt;2021&lt;/span&gt;; Young &amp; Ramakrishnan, &lt;span&gt;2020&lt;/span&gt;). A number of implementation research efforts are underway in countries throughout the world piloting MMS as a replacement for IFA implemented through antenatal care (ANC) (Horino et al., &lt;span&gt;2021&lt;/span&gt;; King et al., &lt;span&gt;2020&lt;/span&gt;). In contrast, it is less clear how BEP supplementation in pregnancy should be implemented as few examples of BEP supplementation programmes in pregnancy exist outside of emergency settings. This may be due to the high cost of food and the unique challenges of working with food commodities including storage and distribution.&lt;/p&gt;&lt;p&gt;The WHO specifically recommends a population-based approach for BEP supplementation, focused on areas in which the population prevalence of low body-mass index (&lt;18.5 kg/m&lt;sup&gt;2&lt;/sup&gt;) is greater than 20% (WHO, &lt;span&gt;2016&lt;/span&gt;). Only two countries (Bangladesh and India) meet this criteria at a national level (Christian et al., &lt;span&gt;2020&lt;/span&gt;), although many countries have subnational regions that exceed this prevalence (Victora et al., &lt;span&gt;2021&lt;/span&gt;). While WHO guidelines do not presently recommend the identification and supplementation of individual undernourished pregnant women, it has been argued that such an approach might optimise the benefits and costs of BEP supplementation (Christian et al., &lt;span&gt;2020&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;Other than India, with its large national ICDS programme, Bangladesh is one of the few countries with experience implementing a large-scale nutrition programme that included food supplementation of pregnant women. The Bangladesh Integrated Nutrition Programme (BINP) and National Nutrition Project (NNP), implemented from 1995 to 2006 was a large programme in rural Bangladesh that ","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"20 S6","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13639","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331930","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":"Experiences, acceptability and barriers to calcium supplementation during pregnancy in Dar es Salaam, Tanzania","authors":"Emmy O. Metta,&nbsp;Alfa Muhihi,&nbsp;Heavenlight A. Paulo,&nbsp;Christopher R. Sudfeld,&nbsp;Anna Kaale,&nbsp;Nandita Perumal,&nbsp;Mary Mwanyika-Sando,&nbsp;Ndeniria O. Swai,&nbsp;Christopher P. Duggan,&nbsp;Honorati Masanja,&nbsp;Blair J. Wylie,&nbsp;Andrea B. Pembe,&nbsp;Wafaie Fawzi","doi":"10.1111/mcn.13732","DOIUrl":"10.1111/mcn.13732","url":null,"abstract":"<p>Calcium supplementation in pregnancy is recommended in contexts with low dietary calcium intake to reduce the risk of pre-eclampsia and its complications. The World Health Organisation suggested high-dose calcium supplementation (1500–2000 mg/day), divided into three doses and taken at different times from daily iron-folic supplements. We conducted a mixed methods evaluation study to assess experiences, acceptability and barriers to high-dose calcium supplementation from the perspectives of pregnant women and antenatal health care providers at two public health facilities in Dar es Salaam, Tanzania. Descriptive statistics and thematic analysis were used to characterise acceptability, barriers and overall experiences of using high-dose calcium supplementation. Pregnant women in the cohort were aged 19–41 years, with 32.4% being primiparous. The proportion of pregnant women who liked calcium supplements ‘a lot’ decreased from 50.2% at the first visit to 31.8% at the last antenatal follow-up visit. Adherence was 71.3% (interquartile range: 50.5%, 89.3%), with only 24.0% of the participants taking 90% or more of the required supplements. Although participants expressed positive attitudes towards using calcium supplements, they also voiced concerns about the large size, side effects, the potential to forget and the burden of taking calcium supplements three times per day. Antenatal health care providers also affirmed the high burden of taking calcium supplements in addition to iron-folic acid supplements. Participants expressed the acceptability of using calcium supplements during pregnancy, but adherence to three doses per day posed challenges to pregnant women. Reducing the number of calcium supplement doses per day may improve adherence.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309060","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}