Formative research in Ethiopia and Bangladesh
Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries
Bibliographic Data
Background: As countries transition from implementing iron folic acid (IFA) to multiple micronutrient supplements (MMS) for pregnant women, they need accurate data on who is being reached with these interventions. The aim of our formative research in Ethiopia and Bangladesh was to design updated household survey questions, response options, and visual aids to measure coverage of prenatal micronutrient supplements. Methods: In phase I, we landscaped health providers and retailers to identify prenatal micronutrient products available in each country and interviewed currently pregnant women (CPW) and recently delivered women (RDW) about how they differentiated among micronutrient products. In phase II, we used these findings to draft survey questions and visual aids. In phase III, we iteratively tested and refined the draft tools through cognitive interviews with women. Results: We had 73 participants in Ethiopia and 132 in Bangladesh, encompassing CPW, RDW, healthcare workers, and retailers. Women in both contexts distinguished among micronutrient products based on colour, shape, packaging, and perceived purpose. In cognitive tests, women generally understood the English term 'iron' as a catch-all term for any iron-containing supplement. Women did not recognise any specific term for multivitamins or MMS. Shorter recalls of seven days or one month for adherence were feasible for respondents. Conclusions: It is challenging for the measurement community to identify terms and images that help women distinguish between supplement types. The final set of survey questions developed as part of this research is comprehensible and can be feasibly adapted and used in multi-topic surveys in MMS contexts, but requires validation
Behavior change communication · Developing country · Formative assessment · Micronutrient · Micronutrient deficiency · Pregnancy · Prenatal care · Public health · Child Nutrition and Water Access · Folate and B Vitamins Research · Iron Metabolism and Disorders
Measuring Coverage in MNCH
Essential Ethnographic Methods
Low-dose calcium supplementation during pregnancy in low and middle-income countries
Nutrition data use and needs
Validation studies for population-based intervention coverage indicators
Assessing the validity of indicators of the quality of maternal and newborn health care in Kenya
Validation of maternal report of nutrition‐related interventions and counselling during antenatal care in southern Nepal
Piloting Multiple Micronutrient Supplementation Within the Routine Antenatal Care System in Ethiopia
Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
Food categorizations among low-income women living in three different urban contexts
Cognitive testing of questions about antenatal care and nutrition interventions in southern Nepal
Cross-Cultural Cognitive Interviewing
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