Preference and acceptability of alternative delivery vehicles for prenatal calcium supplementation among pregnant women in urban Bangladesh (256.2)

Abstract

Prenatal calcium supplementation is recommended by the WHO to decrease the risk of preeclampsia when dietary calcium intake is low; yet, this recommendation has not been successfully implemented to date. We aimed to evaluate preference and acceptability of alternate delivery vehicles for prenatal calcium supplementation (conventional tablets, chewable tablets, unflavored powder, and flavored powder) among pregnant women in urban Bangladesh. In a modified discrete‐choice experiment, pregnant women (n = 132) completed a 4‐day ‘run‐in period’ in which each option was sampled once, followed by a 21‐day ‘selection period’ during which participants freely selected a single option per day. Preference was objectively based on the probability of selection of each option; acceptability was assessed using questionnaires. Conventional tablets demonstrated the highest probability of selection (62%); the probability of selection of chewable tablets (19%), flavored powder (12%), and unflavored powder (5%) were all significantly lower than for conventional tablets (P < 0.001). Conventional tablets were also more acceptable based on subjective reports. Observation of actual use and expressed perceptions showed that a conventional tablet is likely to be the most successful prenatal calcium supplement for scale‐up of the WHO recommendation in Bangladesh.Grant Funding Source: Supported by the Hospital for Sick Children and Sprinkles Global Health Initiative