Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries
Background As countries transition from iron folic acid (IFA) to multiple micronutrient supplements (MMS) for pregnant women, they need accurate data on who is being reached with these interventions. The aim of our formative research in Ethiopia and Bangladesh was to design updated household survey...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Preprint |
| Language: | Inglés |
| Published: |
Gates Foundation
2025
|
| Subjects: | |
| Online Access: | https://hdl.handle.net/10568/179920 |
| _version_ | 1855522618892877824 |
|---|---|
| author | Walton, Shelley Wood, Ellina Berhane, Hanna Y. Workneh, Firehiwot Ferdaweke, Fiker Billah, Sk Masum Lotus, Sharif Uddin Munos, Melinda Kim, Sunny S. Manohar, Swetha Nguyen, Phuong Hong Azeem, Syed Shehryar Heidkamp, Rebecca |
| author_browse | Azeem, Syed Shehryar Berhane, Hanna Y. Billah, Sk Masum Ferdaweke, Fiker Heidkamp, Rebecca Kim, Sunny S. Lotus, Sharif Uddin Manohar, Swetha Munos, Melinda Nguyen, Phuong Hong Walton, Shelley Wood, Ellina Workneh, Firehiwot |
| author_facet | Walton, Shelley Wood, Ellina Berhane, Hanna Y. Workneh, Firehiwot Ferdaweke, Fiker Billah, Sk Masum Lotus, Sharif Uddin Munos, Melinda Kim, Sunny S. Manohar, Swetha Nguyen, Phuong Hong Azeem, Syed Shehryar Heidkamp, Rebecca |
| author_sort | Walton, Shelley |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background
As countries transition from iron folic acid (IFA) to multiple micronutrient supplements (MMS) for pregnant women, they need accurate data on who is being reached with these interventions. The aim of our formative research in Ethiopia and Bangladesh was to design updated household survey questions, response options, and visual aids to measure coverage of prenatal micronutrient supplements.
Methods
In Phase I, we landscaped health providers and retailers to identify prenatal micronutrient products available in each country and interviewed currently pregnant women (CPW) and recently delivered women (RDW) about how they differentiated among micronutrient products. In Phase II, we used these findings to draft survey questions and visual aids. In Phase III, we iteratively tested and refined the draft tools through cognitive interviews with women.
Results
The total number of study participants, including CPW, RDW, healthcare workers, and retailers, was 73 in Ethiopia and 132 in Bangladesh. Women in both contexts distinguished among micronutrient products based on color, shape, packaging, and perceived purpose. In cognitive tests, women generally understood the English term “iron” as a catch-all term for any iron-containing supplement. No specific term for multivitamin or MMS was consistently recognized by women. Shorter recalls of 7 days or 1 month for adherence were feasible for respondents.
Conclusions
It is challenging to identify terms and images that help women distinguish between supplement types. The final set of questions are feasible for adaptation and use in multi-topic surveys, in contexts with MMS but require validation. |
| format | Preprint |
| id | CGSpace179920 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Gates Foundation |
| publisherStr | Gates Foundation |
| record_format | dspace |
| spelling | CGSpace1799202026-01-15T16:28:09Z Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries Walton, Shelley Wood, Ellina Berhane, Hanna Y. Workneh, Firehiwot Ferdaweke, Fiker Billah, Sk Masum Lotus, Sharif Uddin Munos, Melinda Kim, Sunny S. Manohar, Swetha Nguyen, Phuong Hong Azeem, Syed Shehryar Heidkamp, Rebecca micronutrients household surveys supplements developing countries maternal nutrition gender Background As countries transition from iron folic acid (IFA) to multiple micronutrient supplements (MMS) for pregnant women, they need accurate data on who is being reached with these interventions. The aim of our formative research in Ethiopia and Bangladesh was to design updated household survey questions, response options, and visual aids to measure coverage of prenatal micronutrient supplements. Methods In Phase I, we landscaped health providers and retailers to identify prenatal micronutrient products available in each country and interviewed currently pregnant women (CPW) and recently delivered women (RDW) about how they differentiated among micronutrient products. In Phase II, we used these findings to draft survey questions and visual aids. In Phase III, we iteratively tested and refined the draft tools through cognitive interviews with women. Results The total number of study participants, including CPW, RDW, healthcare workers, and retailers, was 73 in Ethiopia and 132 in Bangladesh. Women in both contexts distinguished among micronutrient products based on color, shape, packaging, and perceived purpose. In cognitive tests, women generally understood the English term “iron” as a catch-all term for any iron-containing supplement. No specific term for multivitamin or MMS was consistently recognized by women. Shorter recalls of 7 days or 1 month for adherence were feasible for respondents. Conclusions It is challenging to identify terms and images that help women distinguish between supplement types. The final set of questions are feasible for adaptation and use in multi-topic surveys, in contexts with MMS but require validation. 2025-12-16 2026-01-15T16:28:08Z 2026-01-15T16:28:08Z Preprint https://hdl.handle.net/10568/179920 en Open Access Gates Foundation Walton, Shelley; Wood, Ellina; Berhane, Hanna Y.; Workneh, Firehiwot; Ferdaweke, Fiker; et al. 2025. Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries. VeriXiv Preprint. https://doi.org/10.12688/verixiv.2475.1 |
| spellingShingle | micronutrients household surveys supplements developing countries maternal nutrition gender Walton, Shelley Wood, Ellina Berhane, Hanna Y. Workneh, Firehiwot Ferdaweke, Fiker Billah, Sk Masum Lotus, Sharif Uddin Munos, Melinda Kim, Sunny S. Manohar, Swetha Nguyen, Phuong Hong Azeem, Syed Shehryar Heidkamp, Rebecca Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries |
| title | Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries |
| title_full | Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries |
| title_fullStr | Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries |
| title_full_unstemmed | Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries |
| title_short | Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries |
| title_sort | formative research in ethiopia and bangladesh strengthening household survey measures of maternal micronutrient supplementation in low and middle income countries |
| topic | micronutrients household surveys supplements developing countries maternal nutrition gender |
| url | https://hdl.handle.net/10568/179920 |
| work_keys_str_mv | AT waltonshelley formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT woodellina formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT berhanehannay formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT worknehfirehiwot formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT ferdawekefiker formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT billahskmasum formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT lotussharifuddin formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT munosmelinda formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT kimsunnys formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT manoharswetha formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT nguyenphuonghong formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT azeemsyedshehryar formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries AT heidkamprebecca formativeresearchinethiopiaandbangladeshstrengtheninghouseholdsurveymeasuresofmaternalmicronutrientsupplementationinlowandmiddleincomecountries |