Abstract
Background:The demand for iron and folic acid, is greatly increased during pregnancy. The high demand is not met through diet due to insufficiency or reduced bioavailability of nutrients among women from low income countries. Thus, iron and folic acid supplementation (IFAS) is a promising interventional strategy for control of anaemia during pregnancy. Kenya adopted the global IFAS intervention with a target of 80% coverage by 2017, however, the compliance remains low. Increasing awareness, counselling, communication and community education on IFAS have improved compliance among pregnant women. Thus, we aimed to determine: availability, practices, and content of IFAS counselling on knowledge of antenatal mothers attending health facilities in Kiambu County, Kenya.Methods:A cross-sectional study involving 364 pregnant women aged 15-49 years attending antenatal clinic. A two stage cluster sampling, including one sub-county and five public primary health facilities were used. A pre-tested structured questionnaire consisting of socio-demographic data, maternal knowledge and counselling on IFAS was used. An observation checklist was used to observe practices and content of antenatal counselling session in each facility. Data was analysed using STATA in which descriptive and inferential statistics were computed.Results:Of 364 respondents, less than half (40.9%) scored high on knowledge on IFAS. Women who were counselled on duration of IFAS intake, side effects, and their mitigation were more likely (p <0.005) to have high IFAS knowledge. Although all the health facilities had varied IFAS posters displayed, none had key IFAS counselling documents.Conclusion:Content of counselling substantially contributed to high level of knowledge on IFAS among pregnant women. Counselling information on the duration of IFAS supplementation, IFAS side effects, and their management are the predictors of IFAS knowledge among pregnant women. This underscores the need to strengthen focused and targeted IFAS counselling for pregnant women to improve compliance and pregnancy outcomes.
Highlights
Nutritional status during conception and pregnancy is a predictor of maternal and infant outcomes[1]
The global prevalence of anaemia in pregnancy ranges from 41.8-43.8% with the greatest (61.3%) burden being found in Africa South East Asia at 52.5%6,7
Our findings showed: (i) less than 50% of the pregnant women had high iron and folic acid supplementation (IFAS) knowledge level; (ii) apart from IFAS posters, other counselling guides were scarcely available in the health facilities; (iii) the content of counselling determined the level of IFAS knowledge
Summary
Nutritional status during conception and pregnancy is a predictor of maternal and infant outcomes[1]. The levels of body stores for most critical nutrients, iron and folate, are usually suboptimal by the time of conception among most women in developing countries, their requirement is greater resulting in a need for supplementation. We aimed to determine: availability, practices, and content of IFAS counselling on knowledge of antenatal mothers attending health facilities in Kiambu County, Kenya. Counselling information on the duration of IFAS supplementation, IFAS side effects, and their management are the predictors of IFAS knowledge among pregnant women This underscores the need to strengthen focused and targeted IFAS counselling for pregnant women to improve compliance and pregnancy outcomes
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