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Session: Innovative Approaches to Global Nutrition Research (Oral 1)

(OR01-07-23) Validation of Pregnant Women’s Recall of Iron-Folic Acid Supplements Consumed and Nutrition Counseling Received During Antenatal Care in Burkina Faso

Saturday, July 22, 2023
11:00 AM – 11:12 AM ET
Location:  Constitution B

    Presenting Author(s)

  • RZ

    Rock R. Zagré, MS

    Research Analyst
    International Food Policy Research Institute
    Dakar, Dakar, Senegal

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Celeste Sununtnasuk, MS

    Project Manager
    International Food Policy Research Institute
    Washington, District of Columbia, United States

  • MM

    Melinda Munos, PhD

    Johns Hopkins University
    Baltimore, Maryland, United States

  • RH

    Rebecca A. Heidkamp, PhD

    Johns Hopkins University
    Baltimore, Maryland, United States

  • Sunny S. Kim, PhD, MPH, PhD

    Research Fellow
    IFPRI
    Washington, District of Columbia, United States

Disclosure(s):
Rock R. Zagré, MS: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Limited evidence exists on the accuracy of maternal report on coverage of nutrition interventions such as iron-folic acid (IFA) supplementation and counseling during antenatal care (ANC) during household surveys. However, studies have found poor validity of IFA and nutrition counselling coverage when women are interviewed postpartum. We assessed the validity of recall of IFA supplements consumed during pregnancy and nutrition counseling received during ANC among currently pregnant women and examined factors associated with reporting accuracy.

Methods: A cross-sectional survey conducted in 2019, which included structured interviews with direct observation of IFA blister packets (637 pregnant women) and direct observations of ANC followed by exit interviews (160 pregnant women), provided data on IFA received and consumed in the past 1 month and ANC services received. Individual-level validity was assessed by calculating indicator sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). The inflation factor (IF) measured population-level bias. Multivariable regression models were used to assess factors associated with accurate recall.

Results: Pregnant women reported the number of IFA tablets consumed in the past 1 month with high accuracy (AUC =0.92; 95% CI: 0.90, 0.94), with 5% under-reporting and 14% over-reporting on IFA tablets consumed. Low coverage ( < 40%) was observed for counseling across nearly all nutrition topics during ANC. Accuracy of maternal report of nutrition counseling messages received was moderate, although low cell sizes limited precise estimates. Associations between maternal reporting accuracy and maternal characteristics (age, education, number of ANC visits, and parity) varied by indicator.

Conclusions: Reporting accuracy of IFA supplementation and nutrition counseling received by currently pregnant women were moderate to high, although there was difficulty in recall about specific counseling messages. Pregnant women may be a good source of accurate information on coverage of recently received health and nutrition services.

Funding Sources: Bill & Melinda Gates Foundation through DataDENT project managed by Johns Hopkins University