Public health interventions to improve maternal nutrition during pregnancy: a nationally representative study of iron and folic acid consumption and food supplements in India

• Published in: Public health nutrition 2020-10, Vol.23 (15), p.2671-2686
• Main Authors: Singh, Prashant Kumar, Dubey, Ritam, Singh, Lucky, Kumar, Chandan, Rai, Rajesh Kumar, Singh, Shalini
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anemia; Birth weight; Child development; Children & youth; Cross-Sectional Studies; Diet, Healthy; Dietary Supplements; Female; Folic Acid; Food; Food consumption; Gender; Health facilities; Health promotion; Health Promotion - methods; Health services; Health surveys; Households; Human nutrition; Humans; India; Iron; Malnutrition; Maternal mortality; Medical personnel; Middle Aged; Monitoring and Surveillance; Nutrition; Nutrition research; Polls & surveys; Pregnancy; Prenatal care; Prenatal Nutritional Physiological Phenomena; Proteins; Provisioning; Public Health; Religion; Research Paper; Rural areas; Socioeconomic factors; Southern Hemisphere; Syrup; Syrups; Undernutrition; Variables; Vitamin B; Womens health; Young Adult
• ISSN: 1368-9800; 1475-2727
• DOI: 10.1017/S1368980020001007

Despite a reduction in maternal mortality in recent years, a high rate of anaemia and other nutrient inadequacies during pregnancy pose a serious threat to mothers and their children in the Global South. Using the framework of the WHO-Commission on Social Determinants of Health, this study examines the socioeconomic, programmatic and contextual factors associated with the consumption of iron and folic acid (IFA) tablets/syrup for at least 100 d (IFA100) and receiving supplementary food (SF) by pregnant women in India. We analysed a nationally representative cross-sectional survey of over 190 898 ever-married women aged 15-49 years who were interviewed as part of the National Family Health Survey (NFHS) conducted during 2015-16, who had at least one live birth preceding 5 years of the survey. All twenty-nine states and seven union territories of India. Ever-married women aged 15-49 years. Less than one-third of women were found to be consuming IFA100, and a little over half received SF during their last pregnancy. The consumption of IFA100 was likely to improve with women's education, household wealth, early and more prenatal visits, and in a community with high pregnancy registration. Higher parity, early and more prenatal visits, contact with community health workers during pregnancy, belonging to a poor household and living in an aggregated poor community and rural area positively determine whether a woman might receive SF during pregnancy. Continuous monitoring and evaluation of provisioning IFA and SF in targeted groups and communities is a key to expanding the coverage and reducing the burden of undernutrition during pregnancy.