Plausible Evidence of Effectiveness of an Iron-Supplementation Programme for Pregnant and Post-Partum Women in Rural Bangladesh

Abstract

Since 1978 iron and folic acid pills have been distributed, along with other family-planning and health services, to women in Matlab subdistrict, Bangladesh, through fortnightly visits of community health workers. In 1986 the iron dose was set at three pills daily (198 mg of iron) during pregnancy and two pills daily for 6 months post-partum. Haemoglobin concentrations were determined in a representative sample of 218 women who gave birth from June through August 1994 and who were followed prospectively from 0.5 to 9 months post-partum. At 0.5 months post-partum, 88% of women reported that they had taken iron pills on the previous day. The prevalence of anaemia declined from 36% at 0.5 months to 9% at 9 months post-partum, with an overall average prevalence of 23% in this period. To estimate the impact of the programme, these results were compared to anaemia results from representative samples of non-pregnant women in Matlab in 1975 and 1976 and in three other rural communities in Bangladesh in 1996. The estimated reduction in the prevalence of anaemia resulting from the programme ranged from 48% to 70%, and the estimated increase in haemoglobin concentration ranged from 0.9 to 2.1 g/dl. This evidence suggests that the Matlab programme has been highly effective in controlling anaemia.