Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Midwifery, Institute of Medicine and Health Science, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia.
Syst Rev. 2018 Jul 25;7(1):107. doi: 10.1186/s13643-018-0774-x.
Daily iron-folic acid supplementation reduces anemia and various adverse obstetric outcomes such as preterm delivery, low birthweight, hemorrhage, and perinatal and maternal morbidity and mortality. However, its supplementation has not been successful that attributed to several determinants including poor adherence. Therefore, we aimed to conduct a systematic review and meta-analysis on the prevalence and determinants of adherence to prenatal iron-folic acid supplementation in low- and middle-income countries. In addition, we will develop a conceptual framework in the context of low- and middle-income countries (LMIC).
METHODS/DESIGN: We will search PubMed, MEDLINE, EMBASE, EBSCO, Web of Science, SCOPUS, WHO Global Index Medicus, and African Journals Online (AJOL) databases to retrieve relevant literatures. Observational (i.e., case-control, cohort, cross-sectional, survey, and surveillance reports) and quasi-randomized and randomized controlled trial studies conducted in LMIC will be included. The Newcastle-Ottawa Scale (NOS) and Joanna Briggs Institute (JBI) critical appraisal checklist will be used to assess the quality of observational and randomized controlled trial studies respectively. The pooled prevalence and odds ratio of determinants of adherence will be generated using a weighted inverse-variance meta-analysis model. Statistical heterogeneity among studies will be assessed by Cochran's Q χ statistics and Higgins (I statistics) method. The result will be presented using forest plots and Harvest plots when necessary. Furthermore, we will perform Jackknife sensitivity and subgroup analysis. Data will be analyzed using comprehensive meta-analysis software (version 2).
Contemporary evidence about the prevalence and determinants of adherence in LMIC will be synthesized to generate up-to-date knowledge. To our knowledge, this is the first systematic review. It would have substantial implications for researchers, clinicians, and policymakers for optimizing maternal and child health outcomes in LMIC.
The protocol has been registered on International Prospective Register of Systematic Review (PROSPERO), University of York Center for Reviews and Dissemination ( https://www.crd.york.ac.uk/ ), registration number CRD42017080245 .
每日补充铁叶酸可减少贫血和各种不良产科结局，如早产、低出生体重、出血以及围产期和母婴发病率和死亡率。然而，补充铁叶酸的效果并不理想，这归因于多种决定因素，包括依从性差。因此，我们旨在对中低收入国家产前铁叶酸补充的依从性的流行率和决定因素进行系统评价和荟萃分析。此外，我们将在中低收入国家（LMIC）的背景下制定一个概念框架。
方法/设计：我们将检索 PubMed、MEDLINE、EMBASE、EBSCO、Web of Science、SCOPUS、世界卫生组织全球医学索引和非洲期刊在线（AJOL）数据库，以检索相关文献。将纳入中低收入国家进行的观察性研究（即病例对照、队列、横断面、调查和监测报告）和准随机对照试验和随机对照试验研究。将使用纽卡斯尔-渥太华量表（NOS）和 Joanna Briggs 研究所（JBI）批判性评价清单分别评估观察性和随机对照试验研究的质量。使用加权倒数方差荟萃分析模型生成依从性决定因素的汇总流行率和优势比。通过 Cochran's Q χ统计量和 Higgins（I 统计量）方法评估研究间的统计异质性。必要时将使用森林图和 Harvest 图展示结果。此外，我们将进行刀切敏感性和亚组分析。数据将使用综合荟萃分析软件（版本 2）进行分析。
将综合中低收入国家的依从性流行率和决定因素的当代证据，以生成最新的知识。据我们所知，这是第一项系统评价。它将对研究人员、临床医生和政策制定者优化中低收入国家的母婴健康结果产生重大影响。
该方案已在国际前瞻性系统评价注册中心（PROSPERO）、约克大学评论与传播中心（https://www.crd.york.ac.uk/）注册，注册号为 CRD42017080245。
