Interventions to increase adherence to micronutrient supplementation during pregnancy: a systematic review.

Abstract

Prenatal micronutrient supplements are cost-effective in reducing nutritional deficiencies and adverse pregnancy and birth outcomes. However, poor adherence remains a potential barrier to the successful implementation of these supplementation programs. This systematic review assessed the effectiveness of interventions designed to increase adherence to prenatal micronutrient supplementation. Following the Cochrane Collaboration Methodology, literature searches were conducted in six electronic databases and gray literature (on July 24, 2020), and abstract screening, data extraction, and risk of bias assessment were conducted independently by two reviewers. We included 22 studies. Interventions that resulted in increased adherence were most of the education-based strategies, consumption monitoring by volunteer health workers or family members, SMS reminders, free provision of supplements, a multicomponent intervention with community mobilization, and a participatory action research intervention. In several studies, increased adherence was accompanied by beneficial effects on pregnancy and birth outcomes. Given the heterogeneity of study designs and methods used to define and measure adherence, a meta-analysis was not appropriate. We identified several potentially effective strategies to improve supplementation adherence, which may need to be adapted to specific contexts when considered for program implementation. However, additional high-quality studies are critically needed to effectively guide policies and programs.

• Authors: Filomena Gomes, Shannon E King, Diana Dallmann, Jenna Golan, Ana Carolina Feldenheimer da Silva, Kristen M Hurley, Gilles Bergeron, Megan W Bourassa, Saurabh Mehta
• Journal: Annals of the New York Academy of Sciences (Ann N Y Acad Sci) Vol. 1493 Issue 1 Pg. 41-58 (06 2021) ISSN: 1749-6632 [Electronic] United States
• PMID: 33400303 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Systematic Review)
• Copyright: © 2021 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of New York Academy of Sciences.

Chemical References

• Micronutrients

Topics

• Dietary Supplements
• Female
• Humans
• Micronutrients (administration & dosage)
• Outcome Assessment, Health Care
• Patient Compliance (psychology, statistics & numerical data)
• Pregnancy
• Prenatal Care (methods)
• Prenatal Education (methods)
• Prenatal Nutritional Physiological Phenomena