Effectiveness of a redesigned iron supplementation delivery system for pregnant women in Negros Occidental, Philippines.

OBJECTIVE

To determine the effectiveness of a redesigned Fe supplementation delivery system (ISDS) in improving Hb concentrations and compliance among pregnant women.

DESIGN

A controlled before and after study design was used. Interviews and Hb measurements of randomly selected pregnant women in both treatment areas were conducted at baseline and after 6 months. The redesigned ISDS, reached by consensus based on the surveys and focus group discussions, involved the health workers in spot mapping and clustering; Fe tablets' distribution, monitoring and promotion; and counselling of pregnant women.

SETTING

Negros Occidental and Negros Oriental, Philippines.

SUBJECTS

In total, 1180 pregnant women given Fe/folic acid tablets daily through the redesigned ISDS in the experimental areas and the existing ISDS in the control areas.

RESULTS

There were significantly more anaemic pregnant women in the experimental than in the control area at baseline (50.7 v. 37.3%; P = 0.001). However, at endline, the anaemia prevalence rate in the experimental area was comparable to that of the control (35.6 v. 33.1%; P = 0.530). Also, the mean Hb concentration increased significantly in the experimental area by 0.5 g/dl (P = 0.002). An increase in the actual number of prenatal visits/trimester in the experimental area was observed (from 0.99 to 1.66; P < 0.0001). Pregnant women in the experimental area were four times more likely to take Fe tablets (OR = 3.79; P < 0.001) and sixteen times more likely to being monitored for Fe intake (OR = 16.86; P < 0.001) compared to the control.

CONCLUSIONS

The redesigned ISDS was effective in improving the Hb concentration and health-related behaviour of pregnant women.