Antenatal Multiple Micronutrient Supplementation in the State of Palestine: A Protocol for Implementation and Evaluation
Rattachement africain : jo, Égypte, us, ch. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
The 2013 Palestinian Micronutrient Survey1 reported high and comparable 1st trimester prevalences of micronutrient deficiencies in the Gaza Strip and West Bank: 23.6% and 21.3% for iron, 67.9% and 49.6% for zinc, 11.4% and 8.8% for vitamin A, 27.9% and 19.1% for B12, 78.6% and 66.7% for vitamin D and 17.5% and 13.2% for vitamin E, respectively. Rates were generally higher among gravida in their 2nd-3rd trimesters. Interim, clinic-based, anemia rates2 in the Gaza Strip and West Bank of 32% and 19% in the first trimester and 71% and 38% in the 2nd and 3rd trimesters, respectively, coupled with food insecurity, dietary inadequacy, civil conflict and stresses from the COVID-19 pandemic, suggest micronutrient deficiencies persist as a public health burden in the State of Palestine. To replace current iron-folic acid (IFA) with a multiple micronutrient supplement (MMS) providing a Recommended Dietary Allowance of 15 essential vitamins and minerals as standard of antenatal care (ANC) in UNWRA clinics and hot spots serving pregnant women in the Gaza (n = 22) in 2021–2 and West Bank (n = 44) in 2022–3. MMS is planned to start in Gaza in the Fall of 2021, where UNRWA antenatal services reach ∼38,000 pregnant women with IFA each year; ∼97% of whom attended ANC ≥ 4 times2. Implementation will follow a randomized, step-wedge procedure whereby MMS will start in the 1st 11 clinics, and six months later, the 2nd group of 11 clinics, providing a design for monitoring and comparing the new MMS to existing IFA programs during an initial 6–8 month period. Outcomes will include indicators of adoption, acceptability, coverage, adherence, fidelity, cost-efficiencies and, as a routine clinical outcome, late pregnancy anemia. Maternal micronutrient deficiencies are common in Palestine3, meriting replacing IFA with MMS. This research protocol will evaluate implementation in the Gaza Strip to provide guidance for launching and improving antenatal MMS delivery throughout the UNRWA health system. UNWRA, Sight and Life, Kirk Humanitarian, Vitamin Angels Alliance, Ministry of Foreign Affairs of Japan, Palestine Ministry of Health.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Antenatal Multiple Micronutrient Supplementation in the State of Palestine: A Protocol for Implementation and Evaluation
- Date Crossref
- 01/06/2021
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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United Nations Relief and Works Agency for Palestine Refugees in the Near East pays non établi dans la noticeOrganisation à but non lucratif
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World Health Organization Regional Office for the Eastern Mediterranean Égypte (code pays fourni par la source)Organisme public
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Johns Hopkins University pays non établi dans la noticeUniversité ou école supérieure
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Sight and Life pays non établi dans la noticeInstitution
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Ministry of Health Nutrition Department pays non établi dans la noticeOrganisme public
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World Health Organization Eastern Mediterranean Regional Office pays non établi dans la noticeInstitution
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Johns Hopkins Bloomberg School of Public Health Sight and Life Global Nutrition Research Institute pays non établi dans la noticeUniversité ou école supérieure
United Nations Relief and Works Agency for Palestine Refugees in the Near East, World Health Organization Regional Office for the Eastern Mediterranean (Égypte) et Johns Hopkins University, avec 4 autres affiliations. Pays d’affiliation : Égypte.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.