Effectiveness of programme approaches to improve the coverage of maternal nutrition interventions in South Asia

Abstract

The nutritional status of women before pregnancy, during pregnancy, and after delivery has far reaching consequences for maternal health and child survival, growth, and development. In South Asia, the high prevalence of short stature, thinness, and anaemia among women of reproductive age underlie the high prevalence of child undernutrition in the region, whereas overweight and obesity are rising concerns. A systematic review of evidence (2000–2017) was conducted to identify barriers and programme approaches to improving the coverage of maternal nutrition interventions in the region. The search strategy used 13 electronic bibliographic databases and 14 websites of development and technical agencies and identified 2,247 citations. Nine studies conducted in Bangladesh ( n = 2), India ( n = 5), Nepal ( n = 1), and Pakistan (n = 1) were selected for the review, and outcomes included the receipt and consumption of iron and folic acid and calcium supplements and the receipt of information on dietary intake during pregnancy. The studies indicate that a range of barriers acting at the individual (maternal), household, and health service delivery levels affects intervention coverage during pregnancy. Programme approaches that were effective in improving intervention coverage addressed barriers at multiple levels and had several common features: use of formative research and client assessments to inform the design of programme approaches and actions; community‐based delivery platforms to increase access to services; engagement of family members, as well as pregnant women, in influencing behavioural change; actions to improve the capacity, supervision, monitoring, and motivation of front‐line service providers to provide information and counselling; and access to free supplements.

Evaluation of a community-based intervention for health and economic empowerment of marginalized women in India

“…There was a perceived change in the utilization of most maternal and child health services by women except for the consumption of IFA tablets and uptake of contraceptives. Low consumption of IFA tablets among women, despite health workers visiting them, has been reported in other studies [ 30 , 33 ]. Plausible explanations for this were forgetfulness (non-compliance), perceived side effects of tablets among women, and low stocks of the tablets at health facilities [ 34 , 35 ].…”

The Effects of Maternal Anemia in Pregnant Women with Respect to the Newborn Weight and the Placental Weight in the Delivery Room

“…Maternal anemia might cause serious fetal and maternal complications during pregnancy (7). The effects of this disorder on the placenta and child weight have been reported in the several studies (8)(9)(10)(11).…”

A case–control analysis of maternal diet and risk of neural tube defects in Bangladesh

“…Multiple barriers exist for ensuring adherence to new diets or to routine supplement use, including mothers' perceptions of risks due to low nutrient intakes, awareness and access to anenatal care, and sufficient supplement supplies (Siekmans, Roche, Kung'u, Desrochers, & De‐Regil, ). Two factors that can help overcome these barriers include community‐based supplement delivery methods and including family‐members in the nutritional and supplement programs (Goudet, Murira, Torlesse, Hatchard, & Busch‐Hallen, ). Nutritional interventions that involved husbands helped improve nutritional outcomes for pregnant wives (Nguyen et al, ).…”