Reviewing Anemia and Iron Folic Acid Supplementation Program in Bangladesh - A Special Article

Rashid, Mohsin; Flora,; Moni, MA; Akhter, Afroza; Mahmud, Zeba

doi:10.3329/bmj.v39i3.9952

Cited by 16 publications

(18 citation statements)

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“…Both IFA and calcium supplementation is recommended during pregnancy, particularly in the settings with low intake of iron and calcium and high prevalence of anemia and/or pre-eclampsia. As in many other countries, IFA supplementation in Bangladesh is designed to be delivered through ANC that functions within the context of the government health-care system [ 39 ]. However, there have been obstacles related to the procurement and distribution of IFA supplements, and many PW do not receive or purchase IFA during ANC [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing maternal nutrition practices in a large scale maternal, newborn and child health program in Bangladesh

et al. 2017

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Improving maternal nutrition practices during pregnancy is essential to save lives and improve health outcomes for both mothers and babies. This paper examines the maternal, household, and health service factors influencing maternal nutrition practices in the context of a large scale maternal, newborn, and child health (MNCH) program in Bangladesh. Data were from a household survey of pregnant (n = 600) and recently delivered women (n = 2,000). Multivariate linear and logistic regression analyses were used to examine the determinants of three outcomes: consumption of iron and folic acid (IFA) tablets, calcium tablets, and diverse diets. Women consumed 94 ± 68 IFA and 82 ± 66 calcium tablets (out of 180 as recommended) during pregnancy, and only half of them consumed an adequately diverse diet. Good nutrition knowledge was the key maternal factor associated with higher consumption of IFA (β = 32.5, 95% CI: 19.5, 45.6) and calcium tablets (β ~31.9, 95% CI: 20.9, 43.0) and diverse diet (OR = 1.8, 95% CI: 1.0–3.1), compared to poor knowledge. Women’s self-efficacy in achieving the recommended practices and perception of enabling social norms were significantly associated with dietary diversity. At the household level, women who reported a high level of husband’s support were more likely to consume IFA (β = 25.0, 95% CI: 18.0, 32.1) and calcium (β = 26.6, 95% CI: 19.4, 33.7) tablets and diverse diet (OR = 1.9, 95% CI: 1.2, 3.3), compared to those who received low support. Health service factors associated with higher intakes of IFA and calcium tablets were early and more prenatal care visits and receipt of free supplements. Combined exposure to several of these factors was attributed to the consumption of an additional 46 IFA and 53 calcium tablets and 17% higher proportions of women consuming diverse diets. Our study shows that improving knowledge, self-efficacy and perceptions of social norms among pregnant women, and increasing husbands’ support, early registration in prenatal care, and provision of free supplements will largely improve maternal nutrition practices.

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Section: Discussionmentioning

confidence: 99%

Factors influencing maternal nutrition practices in a large scale maternal, newborn and child health program in Bangladesh

et al. 2017

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“…Only 15 % of rural pregnant women take at least 100 tablets and 46 % take none. Access to Fe + folic acid supplementation is scarce, as only 27 % of women make three or more antenatal visits ( 32 ) . Hence, supplemental Fe intake among our study group (i.e.…”

Section: Discussionmentioning

confidence: 99%

Determinants of iron status and Hb in the Bangladesh population: the role of groundwater iron

Rahman

Ahmed

Rahman

et al. 2016

Public Health Nutr.

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Objective: Using data from the national micronutrients survey 2011-2012, the present study explored the determinants of Fe status and Hb levels in Bangladesh with a particular focus on groundwater Fe. Design: Cross-sectional study conducted at the nationwide scale. Settings: The survey was conducted in 150 clusters, fifty in each of the three strata of rural, urban and slum. Subjects: Three population groups: pre-school age children (6-59 months; PSAC), school age children (6-14 years; SAC) and non-pregnant non-lactating women (15-49 years; NPNLW). Results: National prevalence of Fe deficiency was 10·7 %, 7·1 % and 3·9-9·5 % in PSAC, NPNLW and SAC, respectively. Prevalence of anaemia was 33·1 % (PSAC), 26·0 % (NPNLW) and 17·1-19·1 % (SAC). Multivariate regression analyses showed that the area with 'predominantly high groundwater Fe' was a determinant of higher serum ferritin levels in NPNLW (standardized β = 0·19; P = 0·03), SAC (standardized β = 0·22; P = 0·01) and PSAC (standardized β = 0·20; P = 0·03). This area also determined higher levels of Hb in PSAC (standardized β =

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“…The National Micronutrient Survey 2011–12 estimated an anemia prevalence of 33% among the children of the age group 6–59 months and 26% among the non-pregnant and non-lactating women [14]. Another study reported that childhood anemia decreased with increasing age, with a prevalence of 64% among children of ages 6–23 months and 42% among children of ages 24–59 months [15, 16]. Such high prevalence reported by multiple studies indicates that anemia is a major public health threat in Bangladesh.…”

Section: Introductionmentioning

confidence: 99%

Association between malnutrition and anemia in under-five children and women of reproductive age: Evidence from Bangladesh Demographic and Health Survey 2011

et al. 2019

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Background Bangladesh is one of the most anemia prone countries in South Asia. Children of age under five years and women of reproductive age are particularly vulnerable in this region. Although several studies have investigated the risk factors of anemia, only few have explored its association with malnutrition, despite its high prevalence in the same group. The objective of this paper is to investigate the association of malnutrition with anemia by conducting separate analyses for under-five children and women of reproductive age using data from the nationally representative 2011 Bangladesh Demographic and Health Survey. Methods Two binary outcome variables are considered separately: presence of anemia in children under five years of age (Hb<11.0 g/dl) and presence of anemia in women of childbearing age (Hb<12.0 g/dl). The exposures of interest corresponding to these two outcomes are stunting (low height-for-age) and low BMI (<18.5 kg/m 2 ), respectively. Preliminary analysis involves estimating the association between exposure and outcome while controlling for a single confounder by computing adjusted odds ratios (adjOR) using the Cochran-Mantel-Haenszel approach in stratified analysis. Later, associations between the exposures and outcomes are estimated separately for under-five children and women of reproductive age by fitting multivariable regression models that adjust simultaneously for several confounders. Results The prevalence of anemia is found to be higher among both the stunted children and women with low BMI compared to their healthy counterparts (Children: 56% vs 48%; women: 50% vs 43%). Furthermore, stunted children and women with low BMI have significantly increased odds of developing anemia, as reflected by the adjusted ORs of 1.76 (95% CI:1.10–2.83) and 1.81 (95% CI: 1.11–3.48), respectively. The association of stunting with anemia in children was modified by their age and socio-economic condition, where risk of being anemic decreases with increasing age but with a lower rate for stunted children from richest family. In addition, stunted children of anemic mothers are at greater risk of being anemic compared to non-stunted children of anemic or non-anemic mothers. Again the association between BMI and anemia in women is modified by the level of education, with risk of anemia being lowest among women with low BMI and higher education. Conclusion Evidence–based policies targeting the vulnerable groups are required to combat anemia and nutritional deficiencies simultaneously under the same program.

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Reviewing Anemia and Iron Folic Acid Supplementation Program in Bangladesh - A Special Article

Cited by 16 publications

References 1 publication

Factors influencing maternal nutrition practices in a large scale maternal, newborn and child health program in Bangladesh

Factors influencing maternal nutrition practices in a large scale maternal, newborn and child health program in Bangladesh

Determinants of iron status and Hb in the Bangladesh population: the role of groundwater iron

Association between malnutrition and anemia in under-five children and women of reproductive age: Evidence from Bangladesh Demographic and Health Survey 2011

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