Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study

Ba, Djibril M.; Ssentongo, Paddy; Kjerulff, Kristen H.; Na, Muzi; Liu, Guodong; Gao, Xiang; Du, Ping

doi:10.1093/cdn/nzz120

Cited by 71 publications

(101 citation statements)

References 47 publications

(60 reference statements)

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“…6 22 We recategorised wealth index from five quintiles into three categories by combining poorest and poorer into one category (called 'lowest'); middle wealth level into the second category (called 'middle) and richer and richest into the third category (called 'highest), as previous researchers have done. [29][30][31] The age of survey respondents at the time of the DHS interview was originally measured as a continuous variable and we recategorised age into three groups for this study (15-24, 25-34 and 35-49 years old).…”

Section: Assessment Of Potential Sociodemographic Factorsmentioning

confidence: 99%

Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Ssentongo

Agbese

et al. 2020

BMJ Open

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ObjectivesBreast cancer is the most prevalent cancer and the second leading cause of cancer-related deaths among women after cervical cancer in much of sub-Saharan Africa. This study aims to examine the prevalence and sociodemographic–socioeconomic factors associated with breast cancer screening among women of reproductive age in sub-Saharan Africa.DesignA weighted population-based cross-sectional study using Demographic and Health Surveys (DHS) data. We used all available data on breast cancer screening from the DHS for four sub-Saharan African countries (Burkina Faso, Ivory Coast, Kenya and Namibia). Breast cancer screening was the outcome of interest for this study. Multivariable Poisson regression was used to identify independent factors associated with breast cancer screening.SettingFour countries participating in the DHS from 2010 to 2014 with data on breast cancer screening.ParticipantsWomen of reproductive age 15–49 years (N=39 646).ResultsThe overall prevalence of breast cancer screening was only 12.9% during the study period, ranging from 5.2% in Ivory Coast to 23.1% in Namibia. Factors associated with breast cancer screening were secondary/higher education with adjusted prevalence ratio (adjusted PR)=2.33 (95% CI: 2.05 to 2.66) compared with no education; older participants, 35–49 years (adjusted PR=1.73, 95% CI : 1.56 to 1.91) compared with younger participants 15–24 years; health insurance coverage (adjusted PR=1.57, 95% CI: 1.47 to 1.68) compared with those with no health insurance and highest socioeconomic status (adjusted PR=1.33, 95% CI : 1.19 to 1.49) compared with lowest socioeconomic status.ConclusionDespite high breast cancer mortality rates in sub-Saharan Africa, the prevalence of breast cancer screening is substantially low and varies gradually across countries and in relation to factors such as education, age, health insurance coverage and household wealth index level. These results highlight the need for increased efforts to improve the uptake of breast cancer screening in sub-Saharan Africa.

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Section: Assessment Of Potential Sociodemographic Factorsmentioning

confidence: 99%

Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Ssentongo

Agbese

et al. 2020

BMJ Open

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“…In sub- Sahara Africa, the overall prevalence of ≥90 days iron supplementation adherence during pregnancy was only 28.7%. 8 Likewise, there is very low adherence to IFA supplementation among pregnant women, which is 11% in Ethiopia. 9 , 10…”

Section: Introductionmentioning

confidence: 99%

Adherence to Iron with Folic Acid Supplementation Among Pregnant Women Attending Antenatal Care in Public Health Centers in Simada District, Northwest Ethiopia: Using Health Belief Model Perspective

Mekonnen¹,

Alemnew²,

Zegeye³

et al. 2021

PPA

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Introduction Even though the World Health Organization recommends daily oral iron with folic acid (IFA) supplementation as part of the antenatal care to prevent anemia, still the utilization remains low in Sub-Saharan Africa, particularly in Ethiopia. Therefore, the aim of this study was to assess the magnitude of adherence of iron with folic acid supplementation and associated factors among pregnant women who were attending antenatal care (ANC). Methods A facility-based cross-sectional study was conducted from February 24 to March 23, 2020. Four hundred and twenty-two participants were selected using systematic random sampling technique. Data were collected using a structured questionnaire through face-to-face interview. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Bivariate and multivariable logistic regression analyses were done to identify associated factors of adherence, and P <0.05 was used as cutoff to determine statistical significance at multivariable logistics regressions. Results In this study, 414 (98%) pregnant women participated. The mean age of the respondents was 28.69 ±SD 5.49 years. The magnitude of adherence of IFA supplementation among pregnant women was 67.6% (95%CI: 63.3–72.5). Pregnant women who had a past history of preterm delivery (AOR=3.70; 95%CI: 1.46–9.37), counseling on IFA supplementation (AOR=2.28; 95%CI: 1.15–4.53), high perceived benefit (AOR=2.72; 95%CI: 1.25–5.90) and high self-efficacy (AOR=2.91; 95%CI: 1.40–6.04) were found to be significant associated factors of adherence to IFA supplementation. Conclusion In this study, adherence to IFA supplementation among pregnant women is relatively high. Past history of preterm delivery, counseling on IFA supplementation, perceived benefit and self-efficiency had association with adherence to IFA supplementation. Proper counseling and health education should be given to pregnant women to increase their adherence.

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“…3 5 Postnatal use of iron supplements (either alone or with folic acid) may also reduce the risk of anaemia in settings with high prevalence of maternal anaemia. 6 Despite the efficacy of these supplements, IFA supplementation during pregnancy is not reaching its potential impact due to a lack of consistent use, attributed to a range of issues including supply and demand factors, [7][8][9][10][11] nonadherence due to side effects, cost and access. Promoting the use of over-thecounter (OTC) or home use of folic acid or IFA supplementation when planning a pregnancy (pre-pregnancy), during pregnancy and/or postnatal (after delivery) may help expand delivery of micronutrient supplementation beyond the clinical care setting and ultimately improve maternal, fetal and newborn health outcomes.…”

Section: What Do the New Findings Imply?mentioning

confidence: 99%

Self-management of iron and folic acid supplementation during pre-pregnancy, pregnancy and postnatal periods: a systematic review

et al. 2021

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IntroductionWhile the use of folic acid pre-pregnancy and iron and folic acid (IFA) during pregnancy and postnatal have been demonstrated to be effective and are recommended interventions by WHO, ensuring individuals adhere to the supplementation regimen can be a challenge. Self-care interventions that support an individual’s ability to promote their own health with or without the support of health workers could help promote the uptake and adherence to supplementation. This systematic review assessed the evidence around self-management of IFA or folic acid supplementation accessed over-the-counter during pre-pregnancy, pregnancy and postnatal periods.MethodsPeer-reviewed studies were included if they compared self-management of IFA or folic acid supplementation with health worker-initiated supplement use on maternal and/or fetal and newborn health outcomes, end-users’ or health workers’ values and preferences, or cost and/or cost-effectiveness. We searched PubMed, CINAHL, LILACS and EMBASE for articles published through November 2020, hand-searched clinical trial registries, reviewed databases and contacted experts in the field. Abstract screening and full-text review were conducted independently by two reviewers.ResultsOverall, 2344 results were identified, and 28 studies were identified for full-text review. All studies were excluded, as they were not primary research, lacked the outcomes of interest, lacked specificity in supplement type, and/or lacked a comparison group.ConclusionNo evidence was identified that distinguishes self-management of folic acid supplements pre-pregnancy and of IFA supplements during pregnancy and postnatal, highlighting a gap in our current understanding of self-care related to dietary supplementation in pregnancy. The findings of this review identify an area for further research to support the current movement towards self-care interventions as an added choice to help individuals more fully attain their reproductive health and rights.Systematic review registration numberPROSPERO CRD42020205548

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Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study

Cited by 71 publications

References 47 publications

Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Adherence to Iron with Folic Acid Supplementation Among Pregnant Women Attending Antenatal Care in Public Health Centers in Simada District, Northwest Ethiopia: Using Health Belief Model Perspective

Self-management of iron and folic acid supplementation during pre-pregnancy, pregnancy and postnatal periods: a systematic review

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