Effect of multi-pronged interventions in reducing low birth weight and maternal anaemia among pregnant women. A community-based interventions research in non-agrarian resource constrained setting of rural Pakistan

Abstract

Abstract
 Objective: To investigate the effect on maternal and infant health of iron plus folate and multiple micronutrient supplements, along with deworming and health education session provided to pregnant women in rural, non-agrarian and food-insecure areas.
 Methods: The quasi-experimental study was conducted in Tharparker and Umerkot districts, Sindh, Pakistan, in 2013-14, and comprised pregnant women in their earlier weeks of pregnancy. The enrolment and follow-up phase entailed 3 visits to each subject. Areas covered by lady health workers were designated as intervention areas, and those with non-LHW population were labelled as non-intervention areas.
 Results: Of the 1204 subjects, 600(49.8%) were in the intervention group and 604(50.2%) were in the non-intervention group. By the end of the follow-up phase, significantly more women had increased number of meals in the intervention group compared to the non-intervention group (p<0.001). There was a significantly higher increase in mean haemoglobin levels and body mass index of women in the intervention arm after 3 and 6 months of interventions (p<0.05). Significantly higher mean birth weight was recorded in intervention areas compared to non-intervention areas (p<0.05).
 Conclusion: Community-based provision of multiple micronutrients to women along with deworming, health education and dietary counselling significantly reduced the prevalence of anaemia and reduced the incidence of low birth weight.
 Key Words: Maternal anaemia, Low birth weight, Multiple micronutrients, Nutrition. Continuous...

Effectiveness of nutrition counseling for pregnant women in low‐ and middle‐income countries to improve maternal and infant behavioral, nutritional, and health outcomes: A systematic review

“…We excluded 95 studies in total (including nine duplicates); 31 were conducted in high income setting; 17 studies were excluded because they did not follow EPOC study design recommendations (Akter et al, 2012; Caut et al, 2019; Della Libera et al, 2011; Gila‐Diaz et al, 2021; Jindal et al, 2021; Kamudoni et al, 2016; Nair et al, 2020; NCT04694235, 2021; Parra et al, 2005; Rifayanto et al, 2021; Santos et al, 2013; Selvakumar, 2015; Shimpuku et al, 2019; Thaver et al, 2020; Wijaya‐Erhardt et al, 2014); 14 studies targeted participants that were not relevant to this review (dos Santos et al, 2019; Fayasari et al, 2019; Fernald et al, 2016; Kimani‐Murage et al, 2013; Kimani‐Murage et al, 2015; Lin et al, 2017; Mwangi et al, 2020; Nguyen et al, 2017; Nguyen et al, 2021; Nugraheni et al, 2020; Owais et al, 2017; Scherbaum et al, 2017; Stewart et al, 2020); 10 did not have a nutrition counseling intervention for pregnant women (Abrha et al, 2020; Diddana et al, 2018; Fan et al, 2010; Ferrari et al, 2020; Gomes et al, 2019; Hajian et al, 2020; Pawalia et al, 2020; RBR‐5jy777, 2019; Sahran et al, 2021; Swaminathan, 2015; Nimbalkar et al, 2017, nutrition counseling was not interactive in eight studies (Abujilban et al, 2018; Adhikari al., 2009; Costa de Oliveira et al, 2018; Delfiani et al, 2021; Deveer al., 2013; Teweldemedhin et al, 2021; Javadi et al, 2020; Nimbalkar et al, 2017); four studies did not describe the nature of the nutrition counseling (RBR‐7yx36h, 2019; Saadatnia et al, 2021; Sirajuddin et al, 2018; TCTR20210317002, 2021) and two studies did not assess the effectiveness of counseling or its modalities (Msh...…”

“…We excluded 95 studies in total (including nine duplicates); 31 were conducted in high income setting; 17 studies were excluded because they did not follow EPOC study design recommendations (Akter et al, 2012 ; Caut et al, 2019 ; Della Libera et al, 2011 ; Gila‐Diaz et al, 2021 ; Jindal et al, 2021 ; Kamudoni et al, 2016 ; Nair et al, 2020 ; NCT04694235, 2021 ; Parra et al, 2005 ; Rifayanto et al, 2021 ; Santos et al, 2013 ; Selvakumar, 2015 ; Shimpuku et al, 2019 ; Thaver et al, 2020 ; Wijaya‐Erhardt et al, 2014 ); 14 studies targeted participants that were not relevant to this review (dos Santos et al, 2019 ; Fayasari et al, 2019 ; Fernald et al, 2016 ; Kimani‐Murage et al, 2013 ; Kimani‐Murage et al, 2015 ; Lin et al, 2017 ; Mwangi et al, 2020; Nguyen et al, 2017 ; Nguyen et al, 2021 ; Nugraheni et al, 2020 ; Owais et al, 2017 ; Scherbaum et al, 2017 ; Stewart et al, 2020 ); 10 did not have a nutrition counseling intervention for pregnant women (Abrha et al, 2020 ; Diddana et al, 2018 ; Fan et al, 2010 ; Ferrari et al, 2020 ; Gomes et al, 2019 ; Hajian et al, 2020 ; Pawalia et al, 2020 ; RBR‐5jy777, 2019 ; Sahran et al, 2021 ; Swaminathan, 2015 ; Nimbalkar et al, 2017 , nutrition counseling was not interactive in eight studies (Abujilban et al, 2018 ; Adhikari al., 2009 ; Costa de Oliveira et al, 2018 ; Delfiani et al, 2021; Deveer al., 2013 ...…”