Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Departments of Nutritional Sciences and Biobehavioral Health, Pennsylvania State University, University Park, PA 16802, USA.
Nutrients. 2018 Aug 12;10(8):1073. doi: 10.3390/nu10081073.
Nutritional status in pregnancy is a key determinant of birth outcomes. In low-income countries, maternal diets are often limited, and daily nutrient supplements are recommended to fill nutrient gaps. As a result, it is important to understand the factors influencing acceptability and utilization of nutrient supplements in these settings. Qualitative data (individual interviews and focus group discussions with pregnant women, household members, and study staff) and quantitative data (unannounced household spot checks) were collected in 24 villages in the Maradi region of south-central Niger. Each village was randomly assigned to one of three study arms, with pregnant women receiving either iron and folic acid (IFA) supplements, multiple micronutrient (MMN) supplements, or medium-quantity lipid-based nutrient supplements (MQ-LNS) for daily consumption during pregnancy. Data were collected longitudinally to capture changes in perspective as women progressed through their pregnancy. Participants accepted all three supplement types, and perceived a wide range of health benefits attributed to supplement consumption. However, several important barriers to appropriate consumption were reported, and rumors about the supplements leading to childbirth complications also decreased utilization. The household spot checks suggested that IFA had the highest level of correct consumption. Overall, despite a stated high level of acceptance and enthusiasm for the supplements among participants and their household members, certain fears, side effects, and organoleptic factors led to decreased utilization. The effectiveness of future programs to improve maternal nutritional status through supplementation may be improved by understanding perceived barriers and facilitating factors among participants and tailoring communication efforts appropriately.
妊娠期间的营养状况是出生结局的关键决定因素。在低收入国家，孕产妇的饮食往往受到限制，建议每日补充营养补充剂以填补营养缺口。因此，了解这些环境中影响营养补充剂可接受性和利用的因素非常重要。在尼日尔中南部马里地区的 24 个村庄收集了定性数据（对孕妇、家庭成员和研究人员进行的个人访谈和焦点小组讨论）和定量数据（不事先通知的家庭抽查）。每个村庄都随机分配到三个研究组之一，孕妇分别接受铁和叶酸（IFA）补充剂、多种微量营养素（MMN）补充剂或中等剂量基于脂质的营养补充剂（MQ-LNS），供怀孕期间每日食用。数据是纵向收集的，以捕捉到女性在怀孕期间观点的变化。参与者接受了所有三种补充剂类型，并认为补充剂具有广泛的健康益处。然而，据报道，存在一些重要的使用障碍，有关补充剂会导致分娩并发症的谣言也降低了利用率。家庭抽查表明，IFA 的正确使用率最高。总体而言，尽管参与者及其家庭成员对补充剂表示高度接受和热情，但某些恐惧、副作用和感官因素导致利用率降低。通过了解参与者和他们的家庭成员的感知障碍和促进因素，并适当调整沟通工作，未来通过补充剂改善孕产妇营养状况的计划可能会更加有效。
