Effect of life skills building education and micronutrient supplements provided from preconception versus the standard of care on low birth weight births among adolescent and young Pakistani women (15–24 years): a prospective, population-based cluster-randomized trial

Baxter, Jo‐Anna B; Wasan, Yaqub; Soofi, Sajid Bashir; Suhag, Zamir; Bhutta, Zulfiqar A

doi:10.1186/s12978-018-0545-0

Cited by 21 publications

(23 citation statements)

References 24 publications

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“…We used cross-sectional data from the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial, collected at enrolment, to perform all analyses. Details on the objectives, methodology, and data collection have previously been published [ 13 , 14 ]. Briefly, the MaPPS Trial is a two-arm, cluster-randomized effectiveness trial of life-skills-building education and multiple micronutrient supplementation provided from preconception among adolescent and young women in rural Pakistan ( Identifier: NCT03287882).…”

Section: Methodsmentioning

confidence: 99%

“…Serum samples were stored at −80 °C until analysis at the Nutrition Research Lab (NRL) at the Aga Khan University (AKU), and assessed for markers of nutritional status, including iron (ferritin concentration), vitamin A (retinol concentration), vitamin D (25-hydroxyvitamin D (25(OH)D) concentration), and the inflammation marker CRP. Ferritin and CRP were assessed using the immunoturbidimetric assay method (Cobas C311 Analyzer, Roche Diagnostics; ferritin kit: FERR4 (Tina-quant Ferritin Gen.4, #04885317 190); CRP kit: CRPLX (C-Reactive Protein [Latex], #20764930 322)); vitamin A using quantitative-high performance liquid chromatography photodiode array detection (Agilent HPLC, 1200/1260 Infinity Series with UV/PDA detection; manual method); and vitamin D using electrochemiluminescence protein binding assay (Diasorin Analyzer, LIAISON; kit: LIAISON ® 25 OH Vitamin D TOTAL Assay, #310600) [ 14 ]. Inter-assay CV values were determined ( Table S1 ).…”

Section: Methodsmentioning

confidence: 99%

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Characterizing Micronutrient Status and Risk Factors among Late Adolescent and Young Women in Rural Pakistan: A Cross-Sectional Assessment of the MaPPS Trial

et al. 2021

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Nutritional deficiencies are a leading underlying risk factor contributing to the global burden of disease. In Pakistan, late adolescence is considered a nutritionally vulnerable period, as micronutrient requirements are increased to support maturation, and dietary staples are nutrient poor. However, there has been limited evaluation of micronutrient status beyond anemia and its determinants. Using cross-sectional data from late adolescent and young women (15–23 years) at enrolment in the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial, we aimed to describe the prevalence of key micronutrient deficiencies of public health concern, and generate hierarchical models to examine associations with proxies for social determinants of health (SDoH). The prevalence of micronutrient deficiencies was high: 53.6% (95% confidence interval (CI): 53.0–54.3%) had anemia; 38.0% (95% CI: 36.4–39.6%) iron deficiency anemia; 31.8% (95% CI: 30.2–33.3%) vitamin A deficiency; and 81.1% (95% CI: 79.8–82.4%) vitamin D deficiency. At least one deficiency was experienced by 91.0% (95% CI: 90.1–92.0%). Few SDoH were maintained in the final hierarchical models, although those maintained were often related to socioeconomic status (e.g., education, occupation). To improve the micronutrient status of late adolescent and young women in Pakistan, a direct micronutrient intervention is warranted, and should be paired with broader poverty alleviation methods.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Characterizing Micronutrient Status and Risk Factors among Late Adolescent and Young Women in Rural Pakistan: A Cross-Sectional Assessment of the MaPPS Trial

et al. 2021

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“…The ongoing Matiari emPowerment and Preconception Supplementation (MaPPS) Trial primarily aims to determine the impact of life skills building education (LSBE) and multiple micronutrient supplementation on anemia prevalence and low birth weight (LBW) among adolescent and young women. (22,23) Assessing MHM practices was a secondary outcome of the trial and embedded within the evaluation framework of larger LSBE intervention. LSBE community sessions are used to inform adolescent girls what to expect during menstruation, what is happening, and aim to dissipate stigma.…”

Section: Methodsmentioning

confidence: 99%

Practices and Predictors of Menstrual Hygiene Management Material Use Among Adolescent and Young Women in Rural Pakistan. A Cross-Sectional Study.

Wasan¹,

Baxter

Rizvi³

et al. 2020

Preprint

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BackgroundIn low- and middle-income countries, women often use inappropriate materials to manage menstruation, which can pose a hazard to their health. Inappropriate menstrual hygiene management (MHM) can also have important downstream consequences beyond physiologic health, including the restriction of adolescent girls’ access to academic pursuits. This impacts one’s quality of life and has potential economic consequences for society. Methods Among menstruating adolescent and young women 15-23 years of age living in rural Pakistan (n = 25,305), we aimed to describe MHM practices and generate a predictive model of the socioeconomic and demographic factors related to the use of MHM materials. Beliefs and barriers around MHM were also summarized. The outcome variable included: those who practiced appropriate (reported use of a sanitary pad or/and new piece of cloth) and inappropriate MHM (reported use of an old cloth and/or nothing). Logistic regression was used to generate the predictive model, with results presented as odds ratios (OR) and 95% confidence interval (CI). ResultsInappropriate MHM practices were reported by 75% of participants. The majority (61.9%) reported using old cloths, 12.6% used nothing and 0.5% used old cloth with sanitary pad. One fourth of participants reported appropriate MHM material use, including, 16.2% sanitary pads, 8.6% new cloth and a few reported using sanitary pads with new cloth (0.2%). Inappropriate MHM practices were more common in lowest wealth quintile (OR 4.41; 95% CI = 2.77 to 7.01, P<0.0001), followed by those with no education (OR 3.9; 95% CI = 3.36 to 4.52, P<0.0001). Mothers were the primary source of information about menarche (84.5%). Among school-going girls, 22% reported not going to school while menstruating. The affordability of menstrual hygiene products, awareness of appropriate practices, access to clean supplies, and cultural beliefs were identified as factors contributing to MHM practices.ConclusionsFindings indicate the need for multi-sectorial efforts to introduce MHM-specific and MHM-sensitive interventions to improve MHM practices, ranging from availability of low-cost MHM materials to the inclusion of MHM education in school curriculums and within community platforms. Trial RegistrationThe trial was registered on ClinicalTrials.gov (Identifier: NCT03287882).

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“…Furthermore, evidence for the applicability of these interventions in low- and middle-income countries (LMICs) is limited, although it has been argued that the health and social benefits of preconception interventions in LMICs could be particularly impactful (Mason et al, 2014). One such preconception intervention has been developed for young women in Pakistan, where a community-based intervention is focussing on life skills education and micronutrient supplementation (Baxter et al, 2018). In Malaysia, a community-based preconception behaviour change intervention is also being implemented with young couples, with a particular emphasis on diabetes prevention (Skau et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Urban young women's preferences for intervention strategies to promote physical and mental health preconception: A Healthy Life Trajectories Initiative (HeLTI)

Draper

Bosire

Prioreschi

et al. 2019

Preventive Medicine Reports

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This study aimed to qualitatively investigate young women's preferences for preconception intervention strategies to promote physical and mental health in a rapidly transitioning, urban setting. Four semi-structured focus group discussions were conducted with young women (n = 29, 18–24 years old) from Soweto, South Africa. Qualitative data were thematically analysed. Two main themes were identified: 1) challenges and needs of intervention beneficiaries; and 2) preferences for intervention strategies (content and delivery). The challenges participants mentioned could be classified as those relating to social pressure, identity, and socioeconomic circumstances. Mental health support appeared to be a greater need than physical health, and this featured in their preferences for intervention content, although a number of physical health topics were also mentioned (healthy eating and contraception). Participants had mixed preferences for intervention materials, ranging from printed to electronic and mobile resources. Their preferences for intervention activities ranged from educational sessions, to fun and interactive practical activities, and activities they could take home. Community health workers (CHWs) were the preferred agent of delivery for interventions, though participants emphasised the importance of CHWs having appropriate interpersonal skills and own life experience. Some women preferred one-on-one sessions with a CHW, while others preferred group sessions. While recognising the value of family sessions, young women were less enthusiastic about this approach. These findings provide valuable formative data for developing effective interventions to optimise young women's preconception health in urban Africa. These contextual realities should be acknowledged when addressing key physical and mental health issues facing young women.

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Effect of life skills building education and micronutrient supplements provided from preconception versus the standard of care on low birth weight births among adolescent and young Pakistani women (15–24 years): a prospective, population-based cluster-randomized trial

Cited by 21 publications

References 24 publications

Characterizing Micronutrient Status and Risk Factors among Late Adolescent and Young Women in Rural Pakistan: A Cross-Sectional Assessment of the MaPPS Trial

Characterizing Micronutrient Status and Risk Factors among Late Adolescent and Young Women in Rural Pakistan: A Cross-Sectional Assessment of the MaPPS Trial

Practices and Predictors of Menstrual Hygiene Management Material Use Among Adolescent and Young Women in Rural Pakistan. A Cross-Sectional Study.

Urban young women's preferences for intervention strategies to promote physical and mental health preconception: A Healthy Life Trajectories Initiative (HeLTI)

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