Effectiveness of a redesigned iron supplementation delivery system for pregnant women in Negros Occidental, Philippines

Abstract

Objective: To determine the effectiveness of a redesigned Fe supplementation delivery system (ISDS) in improving Hb concentrations and compliance among pregnant women. Design: A controlled before and after study design was used. Interviews and Hb measurements of randomly selected pregnant women in both treatment areas were conducted at baseline and after 6 months. The redesigned ISDS, reached by consensus based on the surveys and focus group discussions, involved the health workers in spot mapping and clustering; Fe tablets' distribution, monitoring and promotion; and counselling of pregnant women. Setting: Negros Occidental and Negros Oriental, Philippines. Subjects: In total, 1180 pregnant women given Fe/folic acid tablets daily through the redesigned ISDS in the experimental areas and the existing ISDS in the control areas. Results: There were significantly more anaemic pregnant women in the experimental than in the control area at baseline (50.7 v. 37.3 %; P = 0.001). However, at endline, the anaemia prevalence rate in the experimental area was comparable to that of the control (35.6 v. 33.1 %; P = 0.530). Also, the mean Hb concentration increased significantly in the experimental area by 0.5 g/dl (P = 0.002). An increase in the actual number of prenatal visits/trimester in the experimental area was observed (from 0.99 to 1.66; P < 0.0001). Pregnant women in the experimental area were four times more likely to take Fe tablets (OR = 3.79; P < 0.001) and sixteen times more likely to being monitored for Fe intake (OR = 16.86; P < 0.001) compared to the control. Conclusions: The redesigned ISDS was effective in improving the Hb concentration and health-related behaviour of pregnant women. © The Authors 2008.