Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India
Antenatal care (ANC) is the largest health platform globally for delivering maternal nutrition interventions (MNIs) to pregnant women. Yet, large missed opportunities remain in nutrition service delivery. This paper examines how well evidence-based MNIs were incorporated in national policies and pro...
| Main Authors: | , , , , , |
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| Format: | Journal Article |
| Language: | Inglés |
| Published: |
Wiley
2022
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| Online Access: | https://hdl.handle.net/10568/141118 |
| _version_ | 1855523352513347584 |
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| author | Sanghvi, Tina Nguyen, Phuong Hong Tharaney, Manisha Ghosh, Sebanti Escobar-Alegria, Jessica Kim, Sunny S. |
| author_browse | Escobar-Alegria, Jessica Ghosh, Sebanti Kim, Sunny S. Nguyen, Phuong Hong Sanghvi, Tina Tharaney, Manisha |
| author_facet | Sanghvi, Tina Nguyen, Phuong Hong Tharaney, Manisha Ghosh, Sebanti Escobar-Alegria, Jessica Kim, Sunny S. |
| author_sort | Sanghvi, Tina |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Antenatal care (ANC) is the largest health platform globally for delivering maternal nutrition interventions (MNIs) to pregnant women. Yet, large missed opportunities remain in nutrition service delivery. This paper examines how well evidence-based MNIs were incorporated in national policies and programs in Bangladesh, Burkina Faso, Ethiopia and India. We compared the nutrition content of ANC protocols against global recommendations. We used survey data to elucidate the coverage of micronutrient supplementation, weight gain monitoring, dietary and breastfeeding counselling. We reviewed literature, formative research and program assessments to identify barriers and enabling factors of service provision and maternal nutrition practices. Nutrition information in national policies and protocols was often fragmented, incomplete and did not consistently follow global recommendations. Nationally representative data on MNIs in ANC was inadequate, except for iron and folic acid supplementation. Coverage data from subnational surveys showed similar patterns of strengths and weaknesses. MNI coverage was consistently lower than ANC coverage with the lowest coverage of weight gain monitoring and variable coverage of dietary and breastfeeding counselling. Key common factors associated with coverage were micronutrient supply disruptions; suboptimal counselling on maternal diet, weight gain, and breastfeeding; and limited or no record keeping. Adherence of women to micronutrient supplementation and dietary recommendations was low and associated with late and too few ANC contacts, poor maternal knowledge and self-efficacy, and insufficient family and community support. Models of comprehensive nutrition protocols and health systems that deliver maternal nutrition services in ANC are urgently needed along with national data systems to track progress. |
| format | Journal Article |
| id | CGSpace141118 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Wiley |
| publisherStr | Wiley |
| record_format | dspace |
| spelling | CGSpace1411182025-10-26T13:01:33Z Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India Sanghvi, Tina Nguyen, Phuong Hong Tharaney, Manisha Ghosh, Sebanti Escobar-Alegria, Jessica Kim, Sunny S. infants implementation weight gain pregnancy maternal health nutrition trace elements dietary counselling breastfeeding maternal nutrition perinatal period health care Antenatal care (ANC) is the largest health platform globally for delivering maternal nutrition interventions (MNIs) to pregnant women. Yet, large missed opportunities remain in nutrition service delivery. This paper examines how well evidence-based MNIs were incorporated in national policies and programs in Bangladesh, Burkina Faso, Ethiopia and India. We compared the nutrition content of ANC protocols against global recommendations. We used survey data to elucidate the coverage of micronutrient supplementation, weight gain monitoring, dietary and breastfeeding counselling. We reviewed literature, formative research and program assessments to identify barriers and enabling factors of service provision and maternal nutrition practices. Nutrition information in national policies and protocols was often fragmented, incomplete and did not consistently follow global recommendations. Nationally representative data on MNIs in ANC was inadequate, except for iron and folic acid supplementation. Coverage data from subnational surveys showed similar patterns of strengths and weaknesses. MNI coverage was consistently lower than ANC coverage with the lowest coverage of weight gain monitoring and variable coverage of dietary and breastfeeding counselling. Key common factors associated with coverage were micronutrient supply disruptions; suboptimal counselling on maternal diet, weight gain, and breastfeeding; and limited or no record keeping. Adherence of women to micronutrient supplementation and dietary recommendations was low and associated with late and too few ANC contacts, poor maternal knowledge and self-efficacy, and insufficient family and community support. Models of comprehensive nutrition protocols and health systems that deliver maternal nutrition services in ANC are urgently needed along with national data systems to track progress. 2022-04 2024-04-12T13:37:19Z 2024-04-12T13:37:19Z Journal Article https://hdl.handle.net/10568/141118 en Open Access Wiley Sanghvi, Tina; Nguyen, Phuong Hong; Tharaney, Manisha; Ghosh, Sebanti; Escobar-Alegria, Jessica; Kim, Sunny S.; et al. 2022. Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India. Maternal and Child Nutrition 18(2): e13293. https://doi.org/10.1111/mcn.13293 |
| spellingShingle | infants implementation weight gain pregnancy maternal health nutrition trace elements dietary counselling breastfeeding maternal nutrition perinatal period health care Sanghvi, Tina Nguyen, Phuong Hong Tharaney, Manisha Ghosh, Sebanti Escobar-Alegria, Jessica Kim, Sunny S. Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India |
| title | Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India |
| title_full | Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India |
| title_fullStr | Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India |
| title_full_unstemmed | Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India |
| title_short | Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India |
| title_sort | gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in bangladesh burkina faso ethiopia and india |
| topic | infants implementation weight gain pregnancy maternal health nutrition trace elements dietary counselling breastfeeding maternal nutrition perinatal period health care |
| url | https://hdl.handle.net/10568/141118 |
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