Community approval required for periconceptional adolescent adherence to weekly iron and/or folic acid supplementation: a qualitative study in rural Burkina Faso.

Compaoré, Adélaïde, Gies, Sabine, Brabin, Bernard, Tinto, Halidou and Brabin, Loretta (2018) 'Community approval required for periconceptional adolescent adherence to weekly iron and/or folic acid supplementation: a qualitative study in rural Burkina Faso.'. Reproductive Health, Vol 15, Issue 1, p. 48.

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Abstract

BACKGROUND
Iron deficiency remains a prevalent adolescent health problem in low income countries. Iron supplementation is recommended but improvement of iron status requires good adherence.

OBJECTIVES
We explored factors affecting adolescent adherence to weekly iron and/or folic acid supplements in a setting of low secondary school attendance.
METHODS
Taped in-depth interviews were conducted with participants in a randomised, controlled, periconceptional iron supplementation trial for young nulliparous women living in a rural, malaria endemic region of Burkina Faso. Participants with good, medium or poor adherence were selected. Interviews were transcribed and analysed thematically.
RESULTS
Thirty-nine interviews were conducted. The community initially thought supplements were contraceptives. The potential benefits of giving iron supplementation to unmarried "girls" ahead of pregnancy were not recognised. Trial participation, which required parental consent, remained high but was not openly admitted because iron supplements were thought to be contraceptives. Unmarried non-school attenders, being mobile, were often sent to provide domestic labour in varied locations. This interrupted adherence - as did movement of school girls during vacations and at marriage. Field workers tracked participants and trial provision of free treatment encouraged adherence. Most interviewees did not identify health benefits from taking supplements.
CONCLUSIONS
For success, communities must be convinced of the value of an adolescent intervention. During this safety trial, benefits not routinely available in iron supplementation programmes were important to this low income community, ensuring adolescent participation. Nevertheless, adolescents were obliged to fulfil cultural duties and roles that interfered with regular adherence to the iron supplementation regime.
TRIAL REGISTRATION
Trial Registration at clinicaltrials.gov : NCT01210040.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 320 Child Welfare. Child Health Services. WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 160 Hypochromic anemia WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/s12978-018-0490-y
Depositing User:	Stacy Murtagh
Date Deposited:	28 Mar 2018 15:20
Last Modified:	29 Mar 2018 08:23
URI:	https://archive.lstmed.ac.uk/id/eprint/8417

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