Compliance to micronutrient supplementation in children 3 to 24 months of age from a semi-rural community in Mexico

López-Flores, Fernando; Neufeld, Lynnette M.; García‐Guerra, Armando; Ramakrishnan, Usha

doi:10.1590/s0036-36342012000500003

Cited by 7 publications

(10 citation statements)

References 31 publications

(58 reference statements)

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“…However, we posit that these pathways are likely to overlap, thus we present a number pathways through which women’s education may impact on child nutrition beyond the effects of income, as proposed in the literature. These pathways indicate that women’s education: Transmits information about maternal and child health and nutrition directly to women, improving mothers awareness and knowledge [ 8 , 32 , 43 – 47 ] Teaches numeracy and literacy, making the acquisition of information more easily attainable [ 44 , 48 ] Ensures exposure to new environments, increasing receptivity to modern health and nutrition knowledge [ 44 , 49 ] Builds greater self-confidence, enhancing women’s roles in decision making and their interactions with health-care professionals [ 43 , 46 ] (Though some research indicates this pathway was not present [ 50 , 51 ] Provides women with opportunities to form social networks that support women’s empowerment Is a proxy for other socioeconomic factors and intergenerational or household patterns [ 44 , 49 , 52 , 53 ] Delays age of marriage and first child, resulting in fewer and healthier children [ 54 – 56 ] …”

Section: Discussionmentioning

confidence: 99%

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Education and micronutrient deficiencies: an ecological study exploring interactions between women’s schooling and children’s micronutrient status

et al. 2018

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BackgroundFormal education can be a nutrition-sensitive intervention that supports the scale-up and impact of nutrition-specific actions. Maternal education has long been linked to child survival, growth, and development while adult earnings and nutrition are tied to years in school as a child. However, less is known about the relationship between maternal education and the micronutrient status of children, women and the general population.MethodsUsing country-level data and an ecological study design, we explored the global associations between women’s educational attainment and: a) anemia and vitamin A deficiency (VAD) in children aged 6–59 months; b) anemia in non-pregnant women; and c) zinc deficiency, urinary iodine excretion (UIE), and the proportion of infants protected against iodine deficiency in the general population Cross-sectional relationships (2005–2013) were assessed using linear regression models.ResultsPercentage of women without schooling was negatively associated with all outcomes. Number of years of schooling among women was positively associated with all outcomes except for UIE and the proportion of infants protected against iodine deficiency. Income level was a significant effect modifier of the effect of years of women’s schooling on child anemia as well as of the proportion of women without formal education on zinc deficiency in the population. The relationship was strongest in low-income countries for child anemia, and was not significant in upper middle-income countries. For zinc deficiency, the relationship was not significant in low or lower middle income countries, which may suggest that a minimum threshold of resources needs to be reached before education can influence zinc status.ConclusionsWhile relationships between maternal schooling and micronutrient outcomes vary around the globe, more schooling is generally linked to lower rates of deficiency. These findings draw policy-relevant connections between formal education and anemia and micronutrient status globally. It is necessary to examine the mechanisms through which this relationship may be working at both household and country level.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5312-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…Teaches numeracy and literacy, making the acquisition of information more easily attainable [ 44 , 48 ]…”

Section: Discussionmentioning

confidence: 99%

Education and micronutrient deficiencies: an ecological study exploring interactions between women’s schooling and children’s micronutrient status

et al. 2018

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“…Side effects have traditionally been a concern with other iron supplements as reflected by studies on pregnant women [ 28 , 33 , 34 ] where adherence was negatively influenced. Nevertheless, there are also studies that concluded the other way round [ 35 , 36 ]. In case of MMNP, studies from Bangladesh [ 13 , 25 ] have reported change in color and consistency of stool as common side effects in children.…”

Section: Discussionmentioning

confidence: 99%

Adherence to multiple micronutrient powder among young children in rural Bangladesh: a cross-sectional study

et al. 2015

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BackgroundMultiple micronutrient powder (MMNP) can be sprinkled onto any semisolid food and can be given to young children to address iron deficiency anemia. The female community health volunteers of BRAC (an NGO) known as Shasthya Shebikas (SS) sell MMNP sachets during their regular household visits. Currently there are no data on adherence or real uptake of MMNP by children. The objective of the study was to assess adherence to MMNP and associated factors among children aged 6–59 months in rural Bangladesh.MethodsA cross sectional study was conducted in Saturia Sub-district among 78 children aged 6–59 months who were fed MMNP supplied by BRAC SS in the past 60 days. A one stage cluster sampling technique was used to select mothers with eligible children. Semi-structured questionnaire was used for interviews. A logistic regression model was developed to obtain adjusted odds ratios (AOR) with 95% CI.ResultsSample mean adherence was calculated to be 70%. In multivariate analysis, age of mother in years (AOR = 0.74, 95% CI: 0.61-0.88), households belonging to poorer (AOR = 0.01, 95% CI: 0.00-0.68), middle (AOR = 0.04, 95% CI: 0.00-0.35) and richer (AOR = 0.11, 95% CI: 0.01-0.84) wealth quintiles and mothers who prefer to feed flexibly (AOR = 0.03, 95% CI: 0.00-0.26) were significantly associated with high adherence. Further, for every one unit increase in visit by BRAC SS in the past 60 days, the odds of having high adherence significantly increased by 55% (AOR = 1.55, 95% CI: 1.09-2.20).ConclusionsSS are the key to improving adherence through regular visits to households of MMNP users. However, expanding coverage beyond the vicinity of the SS’s household is a challenge. Perception of families whose children have low adherence should be studied.

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“…An exact definition of "compliance" to iron supplementation is lacking in the literature. A study from Mexico calculated adequate compliance by using the number of days the supplement was consumed and the field staff visited to administer the syrup 27 . We could not use this method because we questioned parents retrospectively.…”

Section: Discussionmentioning

confidence: 99%

“…28 Comparison of three groups revealed multiparity and less maternal education as additional risk factors of IDA. Lopez-Florez et al 27 have drawn attention to lower maternal education as a risk factor for incompliance to iron in infants. We believe that multiparity may also increase risk of IDA of infants as it's linked with maternal anemia.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented

et al. 2018

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Çullas-İlarslan NE, Günay F, İleri DT, Elhan AH, Ertem M, Arsan S. Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented. Turk J Pediatr 2018; 60: 22-31. Iron deficiency anemia (IDA) represents the most common cause of anemia worldwide. Because of potential irreversible neurodevelopmental impairment, its prevention during infancy is essential. We aimed to investigate the frequency of iron insufficiency among infants in a population which routine iron supplementation is implemented; and to examine related risks. A total of 501 infants, aged 9-15 months, were screened with complete blood count and serum ferritin. Infants were divided into two groups. [Group 1 (iron insufficient), [Group 1a: Iron deficiency (ID), Group 1b: IDA (IDA)], Group 2 (Iron sufficient (IS)]. Anemia was recognized in 122 (24.3%) infants. Microcytosis was observed in 110 (90.2%) of anemic infants. Group 2 accounted for 49.5% (n=248) whereas 152 (30.3%) and 101 (20.2%) infants belonged to Groups 1a and 1b, respectively. Multiple logistic regression analysis showed that male gender (OR=1.53; 95%CI 1.07 and 2.17), receiving > 500 ml/day cow`s milk (OR=2.77; 95%CI 0.87 and 8.83) and incompliance to iron supplementation (OR=2.51; 95%CI 1.75 and 3.60) were distinctive characteristics of Group 1 while prevalence of iron insufficiency was higher in infants consuming less formula (OR=3.10; 95%CI 2.00 and 4.80). The most frequent reasons for incompliance were consideration of supplementation as unnecessary (n=69, 31.1%) and neglection (n= 59, 26.6%). Our study demonstrated a high frequency of iron insufficiency among infants in a setting utilizing national iron supplementation and `incompliance` to iron as the most evident risk factor for iron insufficiency. Effective counseling of families by health care providers concerning importance of compliance to iron prophylaxis is essential for prevention of iron insufficiency. We also suggest screening of infants for ID as well as IDA in settings with high frequency of iron insufficiency.

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Compliance to micronutrient supplementation in children 3 to 24 months of age from a semi-rural community in Mexico

Abstract: Compliance to micronutrient supplementation in children 3 to 24 months of age from a semi-rural community in Mexico.

Cited by 7 publications

References 31 publications

Education and micronutrient deficiencies: an ecological study exploring interactions between women’s schooling and children’s micronutrient status

Education and micronutrient deficiencies: an ecological study exploring interactions between women’s schooling and children’s micronutrient status

Adherence to multiple micronutrient powder among young children in rural Bangladesh: a cross-sectional study

Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented

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