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Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study

Anaemia in pregnancy is a persistent health problem in Nepal and could be reduced through nutrition counselling and strengthened iron folic acid supplementation programmes. We analysed 24-hour diet recall data from 846 pregnant women in rural plains Nepal, using linear programming to identify the po...

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Autores principales: Morrison, Joanna, Giri, Romi, James, Philip, Arjyal, Abriti, Kharel, Chandani, Saville, Naomi, Baral, Sushil, Hillman, Sara, Harris-Fry, Helen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277664/
https://www.ncbi.nlm.nih.gov/pubmed/36205216
http://dx.doi.org/10.1017/S0007114522003208
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author Morrison, Joanna
Giri, Romi
James, Philip
Arjyal, Abriti
Kharel, Chandani
Saville, Naomi
Baral, Sushil
Hillman, Sara
Harris-Fry, Helen
author_facet Morrison, Joanna
Giri, Romi
James, Philip
Arjyal, Abriti
Kharel, Chandani
Saville, Naomi
Baral, Sushil
Hillman, Sara
Harris-Fry, Helen
author_sort Morrison, Joanna
collection PubMed
description Anaemia in pregnancy is a persistent health problem in Nepal and could be reduced through nutrition counselling and strengthened iron folic acid supplementation programmes. We analysed 24-hour diet recall data from 846 pregnant women in rural plains Nepal, using linear programming to identify the potential for optimised food-based strategies to increase iron adequacy. We then conducted qualitative research to analyse how anaemia was defined and recognised, how families used food-based strategies to address anaemia, and the acceptability of optimised food-based strategies. We did 16 interviews of recently pregnant mothers, three focus group discussions with fathers, three focus group discussions with mothers-in-law and four interviews with key informants. Dietary analyses showed optimised diets did not achieve 100 % of recommended iron intakes, but iron intakes could be doubled by increasing intakes of green leaves, egg and meat. Families sought to address anaemia through food-based strategies but were often unable to because of the perceived expense of providing an ‘energy-giving’ diet. Some foods were avoided because of religious or cultural taboos, or because they were low status and could evoke social consequences if eaten. There is a need for counselling to offer affordable ways for families to optimise iron adequacy. The participation of communities in tailoring advice to ensure cultural relevance and alignment with local norms is necessary to enable its effectiveness.
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spelling pubmed-102776642023-06-20 Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study Morrison, Joanna Giri, Romi James, Philip Arjyal, Abriti Kharel, Chandani Saville, Naomi Baral, Sushil Hillman, Sara Harris-Fry, Helen Br J Nutr Research Article Anaemia in pregnancy is a persistent health problem in Nepal and could be reduced through nutrition counselling and strengthened iron folic acid supplementation programmes. We analysed 24-hour diet recall data from 846 pregnant women in rural plains Nepal, using linear programming to identify the potential for optimised food-based strategies to increase iron adequacy. We then conducted qualitative research to analyse how anaemia was defined and recognised, how families used food-based strategies to address anaemia, and the acceptability of optimised food-based strategies. We did 16 interviews of recently pregnant mothers, three focus group discussions with fathers, three focus group discussions with mothers-in-law and four interviews with key informants. Dietary analyses showed optimised diets did not achieve 100 % of recommended iron intakes, but iron intakes could be doubled by increasing intakes of green leaves, egg and meat. Families sought to address anaemia through food-based strategies but were often unable to because of the perceived expense of providing an ‘energy-giving’ diet. Some foods were avoided because of religious or cultural taboos, or because they were low status and could evoke social consequences if eaten. There is a need for counselling to offer affordable ways for families to optimise iron adequacy. The participation of communities in tailoring advice to ensure cultural relevance and alignment with local norms is necessary to enable its effectiveness. Cambridge University Press 2023-07-28 2022-10-07 /pmc/articles/PMC10277664/ /pubmed/36205216 http://dx.doi.org/10.1017/S0007114522003208 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Research Article
Morrison, Joanna
Giri, Romi
James, Philip
Arjyal, Abriti
Kharel, Chandani
Saville, Naomi
Baral, Sushil
Hillman, Sara
Harris-Fry, Helen
Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study
title Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study
title_full Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study
title_fullStr Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study
title_full_unstemmed Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study
title_short Assessing food-based strategies to address anaemia in pregnancy in rural plains Nepal: a mixed methods study
title_sort assessing food-based strategies to address anaemia in pregnancy in rural plains nepal: a mixed methods study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277664/
https://www.ncbi.nlm.nih.gov/pubmed/36205216
http://dx.doi.org/10.1017/S0007114522003208
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