If we are to increase the success of programs aimed at improving women’s micronutrient status, there are key areas that will make a world of difference, and starting with community-based action is essential.
Our community-based maternal and newborn health and nutrition project is the largest research project ever undertaken by MI, focused on identifying key areas to dramatically increase the health of women of child-bearing age, pregnant women and their newborns.
With support from the Government of Canada, we demonstrated how to improve the quality and uptake of antenatal care, birth care and postnatal care in hard-to-reach populations in Ethiopia, Kenya, Senegal and Niger.
The lessons learned from this global research will benefit not only these four African countries but can be adapted to many of the poorest country contexts in the world as an innovative way to reach the most vulnerable with an essential and integrated package of health and nutrition services.
Better care for pregnant women
Pregnant women in developing countries do not often have contact with the health care system early enough in pregnancy. This puts them and their newborns at greater risk of illness or death.
Many pregnant women may not access health services until well into the second trimester, which decreases the opportunity to address underlying health issues, such as iron-deficiency anaemia, in a timely fashion. However, for women to have better access to care, they need a strong healthcare system.
Many health and nutrition problems begin before pregnancy and we, as those interested in improving programs for women’s health, should explore novel methods, including social marketing among others, aimed at getting women to seek care for themselves before they start a family. This may also include outreach approaches targeting different groups, including adolescent girls in and out of school.
Getting the right nutrients to women in the right way
Food fortification, including salt iodization, has benefited millions around the world. There is still more work to be done in this area, including the opportunity to expand the amount of fortified products offered through social protection programs.
In many women’s health programs, there are reports of poor adherence rates to iron and folic acid supplementation among pregnant women. Even if women are getting the supplements, we often do not know whether they take them regularly during pregnancy. To improve this, we need to understand why.
As part of our Evidence Generation and Policy work, MI conducts surveys in selected countries about what’s being provided to women (what composition and dose), what information the healthcare worker is providing, and even what the packaging looks like.
Better research, better strategies
A key element to our project was the importance of formative research methodologies to develop better educational strategies within programs.
This formative research can help address barriers that women and healthcare providers identify, and use suggestions from these groups on how to improve access and adherence. This type of program design can be replicated in other countries to improve success in women’s health programs.