Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam

Background: Poor adherence to micronutrient supplementation often limits the effectiveness of public health programs. While predictors of adherence to micronutrient supplementation during pregnancy are well documented, information on adherence to preconception supplements is scarce. The objective of...

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Autores principales: Gonzalez-Casanova, Ines, Nguyen, Phuong Hong, Young, Melissa F., Harding, Kimberly B., Reinhart, Gregory A., Nguyen, Hieu, Nechitillo, Meredith, Truong, Truong V., Pham, Hoa, Nguyen, Son, Neufeld, Lynnette M., Martorell, Reynaldo, Ramakrishnan, Usha
Formato: Journal Article
Lenguaje:Inglés
Publicado: Springer 2017
Materias:
Acceso en línea:https://hdl.handle.net/10568/148146
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author Gonzalez-Casanova, Ines
Nguyen, Phuong Hong
Young, Melissa F.
Harding, Kimberly B.
Reinhart, Gregory A.
Nguyen, Hieu
Nechitillo, Meredith
Truong, Truong V.
Pham, Hoa
Nguyen, Son
Neufeld, Lynnette M.
Martorell, Reynaldo
Ramakrishnan, Usha
author_browse Gonzalez-Casanova, Ines
Harding, Kimberly B.
Martorell, Reynaldo
Nechitillo, Meredith
Neufeld, Lynnette M.
Nguyen, Hieu
Nguyen, Phuong Hong
Nguyen, Son
Pham, Hoa
Ramakrishnan, Usha
Reinhart, Gregory A.
Truong, Truong V.
Young, Melissa F.
author_facet Gonzalez-Casanova, Ines
Nguyen, Phuong Hong
Young, Melissa F.
Harding, Kimberly B.
Reinhart, Gregory A.
Nguyen, Hieu
Nechitillo, Meredith
Truong, Truong V.
Pham, Hoa
Nguyen, Son
Neufeld, Lynnette M.
Martorell, Reynaldo
Ramakrishnan, Usha
author_sort Gonzalez-Casanova, Ines
collection Repository of Agricultural Research Outputs (CGSpace)
description Background: Poor adherence to micronutrient supplementation often limits the effectiveness of public health programs. While predictors of adherence to micronutrient supplementation during pregnancy are well documented, information on adherence to preconception supplements is scarce. The objective of this study was to describe the predictors of adherence to preconception and prenatal micronutrient supplementation among women participating in a randomized control trial in Vietnam. Methods: Adherence data were collected prospectively from a double blind randomized controlled trial in rural Vietnam. Five thousand eleven women of reproductive age were randomized to receive preconception supplements for weekly consumption containing either: Folic Acid, Iron and Folic Acid (IFA), or Multiple Micronutrients. Women who became pregnant received prenatal IFA supplements for daily consumption through delivery. Village health workers visited participants’ homes every two weeks to deliver supplements and record consumption and side effects. Multivariate logistic regression was used to assess individual, household, and programmatic predictors of supplement adherence. Results: Adherence was high with 78 and 82% of the women consuming more than 80% of the preconception and prenatal supplements, respectively. Women of minority ethnicity (OR = 0.78 95% CI = 0.67, 0.91) and farmers (OR = 0.71 95% CI = 0.58, 0.88) were less likely to consume >80% of the preconception supplements while socioeconomic status (SES) (OR = 2.71 highest vs. lowest quintile; 95% CI = 2.10, 3.52) was positively associated with >80% adherence in the entire preconception sample with available information (n = 4417). Women in their first pregnancy had lower prenatal adherence compared to multiparous women. At the programmatic level, each village health worker visit was associated with higher odds of >80% adherence by 3–5% before pregnancy and 18% during pregnancy. Conclusions: Key determinants of adherence included SES, ethnicity, occupation (farmer) and parity which may be helpful for targeting women for counseling on supplement adherence. Increased contact with village health workers was positively associated with adherence to micronutrient supplementation both before conception and during pregnancy indicating the need for resources to support community outreach to women of reproductive age. Trial registration: NCT01665378. Registered on August 12, 2012.
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spelling CGSpace1481462025-12-08T10:29:22Z Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam Gonzalez-Casanova, Ines Nguyen, Phuong Hong Young, Melissa F. Harding, Kimberly B. Reinhart, Gregory A. Nguyen, Hieu Nechitillo, Meredith Truong, Truong V. Pham, Hoa Nguyen, Son Neufeld, Lynnette M. Martorell, Reynaldo Ramakrishnan, Usha gender supplements nutrition mineral supplements children side effects maternal nutrition women Background: Poor adherence to micronutrient supplementation often limits the effectiveness of public health programs. While predictors of adherence to micronutrient supplementation during pregnancy are well documented, information on adherence to preconception supplements is scarce. The objective of this study was to describe the predictors of adherence to preconception and prenatal micronutrient supplementation among women participating in a randomized control trial in Vietnam. Methods: Adherence data were collected prospectively from a double blind randomized controlled trial in rural Vietnam. Five thousand eleven women of reproductive age were randomized to receive preconception supplements for weekly consumption containing either: Folic Acid, Iron and Folic Acid (IFA), or Multiple Micronutrients. Women who became pregnant received prenatal IFA supplements for daily consumption through delivery. Village health workers visited participants’ homes every two weeks to deliver supplements and record consumption and side effects. Multivariate logistic regression was used to assess individual, household, and programmatic predictors of supplement adherence. Results: Adherence was high with 78 and 82% of the women consuming more than 80% of the preconception and prenatal supplements, respectively. Women of minority ethnicity (OR = 0.78 95% CI = 0.67, 0.91) and farmers (OR = 0.71 95% CI = 0.58, 0.88) were less likely to consume >80% of the preconception supplements while socioeconomic status (SES) (OR = 2.71 highest vs. lowest quintile; 95% CI = 2.10, 3.52) was positively associated with >80% adherence in the entire preconception sample with available information (n = 4417). Women in their first pregnancy had lower prenatal adherence compared to multiparous women. At the programmatic level, each village health worker visit was associated with higher odds of >80% adherence by 3–5% before pregnancy and 18% during pregnancy. Conclusions: Key determinants of adherence included SES, ethnicity, occupation (farmer) and parity which may be helpful for targeting women for counseling on supplement adherence. Increased contact with village health workers was positively associated with adherence to micronutrient supplementation both before conception and during pregnancy indicating the need for resources to support community outreach to women of reproductive age. Trial registration: NCT01665378. Registered on August 12, 2012. 2017 2024-06-21T09:23:55Z 2024-06-21T09:23:55Z Journal Article https://hdl.handle.net/10568/148146 en Open Access application/pdf Springer Gonzalez-Casanova, Ines; Nguyen, Phuong Hong; Young, Melissa; Harding, Kimberly B; Reinhart, Gregory A.; Nguyen, Hieu; Nechitillo, Meredith; Truong, Truong V.; Pham, Hoa; Nguyen, Son; Neufeld, Lynnette M.; Martorell, Reynaldo; and Ramakrishnan, Usha. 2017. Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam. BMC Public Health 17: 452: https://doi.org/10.1186/s12889-017-4379-4
spellingShingle gender
supplements
nutrition
mineral supplements
children
side effects
maternal nutrition
women
Gonzalez-Casanova, Ines
Nguyen, Phuong Hong
Young, Melissa F.
Harding, Kimberly B.
Reinhart, Gregory A.
Nguyen, Hieu
Nechitillo, Meredith
Truong, Truong V.
Pham, Hoa
Nguyen, Son
Neufeld, Lynnette M.
Martorell, Reynaldo
Ramakrishnan, Usha
Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam
title Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam
title_full Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam
title_fullStr Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam
title_full_unstemmed Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam
title_short Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam
title_sort predictors of adherence to micronutrient supplementation before and during pregnancy in vietnam
topic gender
supplements
nutrition
mineral supplements
children
side effects
maternal nutrition
women
url https://hdl.handle.net/10568/148146
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