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Validation of Maternal Report of Receipt of Iron–Folic Acid Supplementation during Antenatal Care in Rural Southern Nepal
BACKGROUND: Coverage of iron–folic acid (IFA) supplementation is a key indicator for tracking programmatic progress within and across countries. However, the validity of maternal report of this information during household surveys has yet to be determined. OBJECTIVES: This study aimed to examine the...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754516/ https://www.ncbi.nlm.nih.gov/pubmed/34549300 http://dx.doi.org/10.1093/jn/nxab336 |
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author | Bryce, Emily Munos, Melinda Lama, Tsering Pema Khatry, Subarna K LeClerq, Steve Katz, Joanne |
author_facet | Bryce, Emily Munos, Melinda Lama, Tsering Pema Khatry, Subarna K LeClerq, Steve Katz, Joanne |
author_sort | Bryce, Emily |
collection | PubMed |
description | BACKGROUND: Coverage of iron–folic acid (IFA) supplementation is a key indicator for tracking programmatic progress within and across countries. However, the validity of maternal report of this information during household surveys has yet to be determined. OBJECTIVES: This study aimed to examine the validity of maternal recall of receipt of IFA supplementation during antenatal care (ANC) and factors associated with accuracy of maternal recall. METHODS: A longitudinal cohort design was employed. The direct observation of the IFA received during all ANC visits at the 5 study health posts served as the “gold standard” to the maternal report of IFA received during the postpartum interview. Individual-level validity was assessed by calculating indicator sensitivity, specificity, and AUC. The inflation factor (IF) measured population-level bias. A multivariable log-binomial model was used to assess factors associated with accurate recall. RESULTS: The majority (95.8%) of women were observed receiving IFA during pregnancy. Women overreported the number of IFA tablets received compared with what was observed during ANC visits (mean difference: 45 tablets). Maternal report of any IFA receipt was moderate (AUC = 0.60; 95% CI: 0.50, 0.71), and population bias was low (IF = 1.01). However, the individual-level validity was poor across the 7 IFA tablet count categories; the AUC for categories ranged from misleading to moderate. Driven by the trend of maternal overreport, the IF indicated that maternal report drastically underestimated the coverage of lower tablet categories and overestimated the coverage of higher tablet counts. Accuracy of maternal report was not associated with months since last ANC observation nor any maternal characteristics. CONCLUSIONS: Maternal report of the amount of IFA supplementation received during pregnancy produced extremely biased population coverage and performed poorly to moderately for individual-level validity. It is imperative to improve this indicator because it is used in global frameworks and national program planning. |
format | Online Article Text |
id | pubmed-8754516 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-87545162022-01-14 Validation of Maternal Report of Receipt of Iron–Folic Acid Supplementation during Antenatal Care in Rural Southern Nepal Bryce, Emily Munos, Melinda Lama, Tsering Pema Khatry, Subarna K LeClerq, Steve Katz, Joanne J Nutr Community and International Nutrition BACKGROUND: Coverage of iron–folic acid (IFA) supplementation is a key indicator for tracking programmatic progress within and across countries. However, the validity of maternal report of this information during household surveys has yet to be determined. OBJECTIVES: This study aimed to examine the validity of maternal recall of receipt of IFA supplementation during antenatal care (ANC) and factors associated with accuracy of maternal recall. METHODS: A longitudinal cohort design was employed. The direct observation of the IFA received during all ANC visits at the 5 study health posts served as the “gold standard” to the maternal report of IFA received during the postpartum interview. Individual-level validity was assessed by calculating indicator sensitivity, specificity, and AUC. The inflation factor (IF) measured population-level bias. A multivariable log-binomial model was used to assess factors associated with accurate recall. RESULTS: The majority (95.8%) of women were observed receiving IFA during pregnancy. Women overreported the number of IFA tablets received compared with what was observed during ANC visits (mean difference: 45 tablets). Maternal report of any IFA receipt was moderate (AUC = 0.60; 95% CI: 0.50, 0.71), and population bias was low (IF = 1.01). However, the individual-level validity was poor across the 7 IFA tablet count categories; the AUC for categories ranged from misleading to moderate. Driven by the trend of maternal overreport, the IF indicated that maternal report drastically underestimated the coverage of lower tablet categories and overestimated the coverage of higher tablet counts. Accuracy of maternal report was not associated with months since last ANC observation nor any maternal characteristics. CONCLUSIONS: Maternal report of the amount of IFA supplementation received during pregnancy produced extremely biased population coverage and performed poorly to moderately for individual-level validity. It is imperative to improve this indicator because it is used in global frameworks and national program planning. Oxford University Press 2021-09-21 /pmc/articles/PMC8754516/ /pubmed/34549300 http://dx.doi.org/10.1093/jn/nxab336 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Community and International Nutrition Bryce, Emily Munos, Melinda Lama, Tsering Pema Khatry, Subarna K LeClerq, Steve Katz, Joanne Validation of Maternal Report of Receipt of Iron–Folic Acid Supplementation during Antenatal Care in Rural Southern Nepal |
title | Validation of Maternal Report of Receipt of Iron–Folic Acid Supplementation during Antenatal Care in Rural Southern Nepal |
title_full | Validation of Maternal Report of Receipt of Iron–Folic Acid Supplementation during Antenatal Care in Rural Southern Nepal |
title_fullStr | Validation of Maternal Report of Receipt of Iron–Folic Acid Supplementation during Antenatal Care in Rural Southern Nepal |
title_full_unstemmed | Validation of Maternal Report of Receipt of Iron–Folic Acid Supplementation during Antenatal Care in Rural Southern Nepal |
title_short | Validation of Maternal Report of Receipt of Iron–Folic Acid Supplementation during Antenatal Care in Rural Southern Nepal |
title_sort | validation of maternal report of receipt of iron–folic acid supplementation during antenatal care in rural southern nepal |
topic | Community and International Nutrition |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754516/ https://www.ncbi.nlm.nih.gov/pubmed/34549300 http://dx.doi.org/10.1093/jn/nxab336 |
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