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Effect of a community-based approach of iron and folic acid supplementation on compliance by pregnant women in Kiambu County, Kenya: A quasi-experimental study
No full textIntroduction
Iron and Folic Acid Supplementation (IFAS) is an essential and affordable intervention strategy for prevention of anaemia during pregnancy. The supplements are currently provided for free to pregnant women in Kenya during antenatal care (ANC), but compliance remains low over the years. There is need for diversification of IFAS programme implementation by exploring other distribution channels to complement existing antenatal distribution and ensure consistent access to IFAS supplements.
Objectives
To determine the effect of a community-based approach of IFAS distribution on compliance and assess side-effects experienced and their mitigation by pregnant women in Kiambu County.
Methodology
A pretest-posttest quasi-experimental study design was used, consisting of an intervention and a control group, among 340 pregnant women 15–49 years, in five health facilities in Lari Sub-County in Kiambu County, between June 2016 and March 2017. Community health volunteers provided IFAS supplements, counselling and weekly follow-up to pregnant women in the intervention group while the control group followed standard practice from health facilities. Baseline and endline data were collected during antenatal care and compared. Quantitative data was analyzed using STATA version 14. Analysis of effect of intervention was done using Difference-In-Difference regression approach.
Results
Levels of compliance increased by 8% in intervention group and 6% in control group. There was increased awareness of IFAS side-effects across groups. The intervention group reported experiencing less side-effects and were better able to manage them compared to the control group.
Conclusion
Implementation a community-based approach improved maternal compliance with IFAS, awareness of IFAS side effects and their management, with better improvement being recorded in the intervention group. Hence, there is need to integrate community-based approach with antenatal distribution of IFAS to improve supplementation
Utilizing milk from pooling facilities as a novel approach for foot-and-mouth disease surveillance.
No full textThis study investigated the potential of pooled milk as an alternative sample type for foot-and-mouth disease (FMD) surveillance. Real-time RT-PCR (rRT-PCR) results of pooled milk samples collected weekly from five pooling facilities in Nakuru County, Kenya, were compared with half-month reports of household-level incidence of FMD. These periodic cross-sectional surveys of smallholder farmers were powered to detect a threshold household-level FMD incidence of 2.5% and collected information on trends in milk production and sales. FMD virus (FMDV) RNA was detected in 9/219 milk samples, and using a type-specific rRT-PCR, serotype SAT 1 was identified in 3/9 of these positive samples, concurrent with confirmed outbreaks in the study area. Four milk samples were FMDV RNA-positive during the half-months when at least one farmer reported FMD; that is, the household-level clinical incidence was above a threshold of 2.5%. Additionally, some milk samples were FMDV RNA-positive when there were no reports of FMD by farmers. These results indicate that the pooled milk surveillance system can detect FMD household-level incidence at a 2.5% threshold when up to 26% of farmers contributed milk to pooling facilities, but perhaps even at lower levels of infection (i.e., below 2.5%), or when conventional disease reporting systems fail. Further studies are required to establish a more precise correlation with estimates of household-level clinical incidence, to fully evaluate the reliability of this approach. However, this pilot study highlights the potential use of this non-invasive, routinely collected, cost-effective surveillance tool, to address some of the existing limitations of traditional surveillance methods
