ArticleMaternal & child nutrition2018
Feasibility of integrating calcium and iron-folate supplementation to prevent preeclampsia and anemia in pregnancy in primary healthcare facilities in Kenya.
Article in Maternal & child nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Hypertensive disorders of pregnancy in low- and middle-income countries: a review of antenatal interventions to improve maternal outcomes.Frontiers in global women's health · 2026Pooled it
- A systematic review of methodological approaches and measurement of adherence to micronutrient supplementation among women of reproductive age in low- and middle-income countries.BMC public health · 2025Pooled it
- Pooled it
- Integrating Women and Girls' Nutrition Services into Health Systems in Low- and Middle-Income Countries: A Systematic Review.Nutrients · 2022Pooled it
- Trial
- Integrating Calcium Into Antenatal Iron-Folic Acid Supplementation in Ethiopia: Women's Experiences, Perceptions of Acceptability, and Strategies to Support Calcium Supplement Adherence.Global health, science and practice · 2020Trial
- Engaging Family Members to Support Exclusive Breastfeeding, Responsive care, and Antiretroviral Therapy Adherence Among Families with Children who are HIV-Exposed and Uninfected.AIDS and behavior · 2024Article
- Synthesis of evidence for managing hypertensive disorders of pregnancy in low middle-income countries: a scoping review.BMC pregnancy and childbirth · 2024Article
- Counseling pregnant women on calcium: effects on calcium intake.Journal of perinatal medicine · 2023Article
- Calcium supplementation in pregnancy: An analysis of potential determinants in an under-resourced setting.PloS one · 2023Article
- Calcium supplementation for the prevention of hypertensive disorders of pregnancy: current evidence and programmatic considerations.Annals of the New York Academy of Sciences · 2022Article
- Specificity Matters: Unpacking Impact Pathways of Individual Interventions within Bundled Packages Helps Interpret the Limited Impacts of a Maternal Nutrition Intervention in India.The Journal of nutrition · 2022Article
- Spatio-temporal trends in anaemia among pregnant women, adolescents and preschool children in sub-Saharan Africa.Public health nutrition · 2021Article
- Cost-Effectiveness of Ferrous Fumarate-Folic Acid and Ferrous Gluconate-Multivitamins in a High Prevalence Area of Iron Deficiency Anemia in Indonesia.Therapeutics and clinical risk management · 2021Article
- Article
- Integrating Calcium Supplementation into Facility-Based Antenatal Care Services in Western Kenya: A Qualitative Process Evaluation to Identify Implementation Barriers and Facilitators.Current developments in nutrition · 2018Article
- With adaptation, the WHO guidelines on calcium supplementation for prevention of pre-eclampsia are adopted by pregnant women.Maternal & child nutrition · 2018Article
- Feasibility of integrating calcium and iron-folate supplementation to prevent preeclampsia and anemia in pregnancy in primary healthcare facilities in Kenya.Maternal & child nutrition · 2018Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Calcium (Ca) supplementation to prevent preeclampsia can save maternal and newborn lives, but there are no program models for integration into existing antenatal care platforms. We used a program impact pathway model to guide the design of integrated Ca and iron-folate (IFA) supplementation in Kenya. We provided healthcare providers with job aids (posters and counseling cards), trained them on counseling techniques and supplementation guidelines, and developed behavior change materials for pregnant women (pill-taking calendars). We allocated health facilities to prescribe either 1.0 or 1.5 g/day Ca, with standard IFA. We collected implementation data from 16 facilities and 990 women. We also explored effects of supplementation on percentage of the population meeting recommended daily allowance. Supplements and job aids were available during 90% of facility spot-check episodes; calendar availability was lower (78%). Over 98% of clients received Ca and IFA supplements, but only 76% received enough Ca supplements to last between antenatal care visits. Among clients that still had pills by return date, adherence was 77% and 83% for the IFA and Ca regimen, respectively. When 1.5 g/day of Ca supplements were prescribed, over 75% of participants met recommended daily allowance. Only 54% met the recommended daily allowance when 1.0 g was prescribed. This study illustrates a systematic approach for integrating Ca supplementation into primary healthcare and demonstrates that such integration is feasible when contextual bottlenecks are addressed. Policy makers and program planners should pay attention to supply chain, healthcare worker dispensing behavior, and appropriateness of regimen for their settings.
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