Abstract
Background: Folic acid supplementation is effective in reducing the risk of neural tube defects (NTDs). However, the use of folic acid is low among rural women in China. Nutrition education can provide information about folic acid and encourage its use. The primary objective of this study was to test the effectiveness of a village-based nutrition intervention on folic acid use among rural women. Methods: Sixty villages were randomly selected using multiple-stage sampling and were divided into control and intervention groups. The intervention included nutritional education at village clinics, written materials, and text messages (SMS). Folic acid use knowledge and behavior was assessed at baseline and after the intervention. Results: Self-reported compliance with folic acid supplement use increased from 17.0%–29.2% at baseline to 41.7%–59.2% one year post-intervention. During the same period, the folic acid knowledge score in the intervention group increased from 3.07 to 3.65, significantly higher than the control group (3.11 to 3.35). Multivariate binary logistic regression showed that the women who received folic acid education and SMS intervention were more likely to comply with folic acid supplement recommendations. Conclusions: The results indicated that an integrated village-based folic acid education intervention may be an effective way of promoting folic acid use for the prevention of NTDs in rural women.
Highlights
Neural tube defects (NTDs) are the most common birth defects that contribute to infant mortality and serious disability [1]
The distribution of neural tube defects (NTDs) varies by region, with a higher prevalence in the north compared with the south and in rural compared to urban populations [2]
Six SFAPN villages were selected from each township using simple random sampling, and the sixty total selected villages were randomly assigned to the control group or the intervention group
Summary
Neural tube defects (NTDs) are the most common birth defects that contribute to infant mortality and serious disability [1]. National birth surveillance showed that the NTD incidence is still high in rural areas of China, occurring in 12.9 of. NTDs are preventable if women consume a daily supplement of 400 μg folic acid (FA) before and during conception. Many governments (including China’s) recommend that all women take a daily folic acid supplement for 6 months, starting from 3 months before conception and continuing throughout the first trimester. The use of folic acid is low among rural women in China. The primary objective of this study was to test the effectiveness of a village-based nutrition intervention on folic acid use among rural women. The intervention included nutritional education at village clinics, written materials, and text messages (SMS). Results: Self-reported compliance with folic acid supplement use increased from 17.0%–29.2% at baseline to 41.7%–59.2% one year post-intervention
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