Abstract
BackgroundAdolescence is a critical period for physical and psychological growth and development, and vitamin and mineral requirements are correspondingly increased. Health and health behaviours correspond strongly from adolescence to adulthood. Developing a preconception care package for adolescent and young women in resource-limited settings could serve to empower them to make informed decisions about their nutrition, health, and well-being, as well as function as a platform for the delivery of basic nutrition-related interventions to address undernutrition.MethodsIn this population-based two-arm, cluster-randomized, controlled trial of life skills building education (provided bi-monthly) and multiple micronutrient supplementation (provided twice-weekly; UNIMMAP composition), we aim to evaluate the effectiveness of the intervention on the prevention of anemia (hemoglobin concentration < 12 g/dL) among adolescent and young women (15–24 years) in Matiari district, Pakistan compared to the standard of care. Several secondary objectives related to nutrition (anthropometry [height, weight, middle upper arm circumference (MUAC)], nutritional status [iron, vitamin A, vitamin D]); general health (morbidity, mortality); and empowerment (age at marriage, completion of the 10th grade, use of personal hygienic materials during menstruation) will also be assessed. Participants will be enrolled in the study for a maximum of 2 years.DiscussionEmpowering adolescent and young women with the appropriate knowledge to make informed and healthy decisions will be key to sustained behavioural change throughout the life-course. Although multiple micronutrient deficiencies are known to exist among adolescent and young women in low-resource settings, recommendations on preconception multiple micronutrient supplementation do not exist at this time. This study is expected to offer insight into providing an intervention that includes both education and supplements to non-pregnant adolescent and young women for a prolonged duration of time within the existing public health programmatic context.Trial registrationThis study is part of the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial. The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882) on September 19, 2017.
Highlights
Adolescence is a critical period for physical and psychological growth and development, and vitamin and mineral requirements are correspondingly increased
The Matiari emPowerment and Preconception Supplementation (MaPPS) Matiari emPowerment and preconception supplementation trial (Trial) is a two-arm, cluster-randomized, controlled trial of life skills building education (LSBE) and multiple micronutrients (MMN) supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women, and their infants born within the context of the trial
The plan for the analysis of secondary objectives and outcome measures will be presented elsewhere. In this trial, we aim to assess the effectiveness of providing LSBE and MMN supplementation to non-pregnant adolescent and young women in rural Pakistan from preconception, and compare this intervention with the standard of care on anemia prevalence and other secondary health outcomes
Summary
Adolescence is a critical period for physical and psychological growth and development, and vitamin and mineral requirements are correspondingly increased. When an adolescent becomes pregnant in a resourcelimited setting, her access to education generally stops as a result; yet, educating girls is very effective in raising overall economic productivity, lowering infant and maternal mortality, improving nutrition, and promoting health [5]. This makes determining interventions to improve health outcomes from adolescence of public health importance [2]. The burden of undernutrition and its downstream consequences could be prevented throughout the life course by using appropriate nutrition-specific and nutrition-sensitive interventions, such as MMN supplementation and the empowerment of women to make informed decisions, respectively [5]
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