title: Acceptability of multiple micronutrient supplements by pregnant and lactating women in Mali.
abstract: BACKGROUND
  In Mali, an estimated 73% of pregnant women are anaemic largely due to iron deficiency. National policy recommends women to take iron and folic acid supplements daily from first prenatal contact until 3 months postpartum. However, many pregnant women in Mali could benefit from multiple micronutrient supplements.
  
  
  OBJECTIVE
  To assess pregnant women's acceptability of and adherence to a daily multiple micronutrient supplementation scheme compared with the current daily iron and folic acid supplementation scheme.
  
  
  METHODS
  Seventy pregnant women were allocated to either the daily multiple micronutrient or daily iron and folic acid supplementation scheme. Women started receiving supplements at the end of the first trimester of pregnancy until delivery and throughout the first 3 months postpartum.
  
  
  RESULTS
  No significant differences were observed between comparison groups with respect to women's perceptions about supplement size, colour, taste or flavour. Adherence to the multiple micronutrient supplementation scheme was better (257.5+/-20.9 tablets; average adherence 95.4%) than that to the iron and folic acid supplementation scheme (238.5+/-32.7 tablets; average adherence 92.2%; P=0.008) although both were very good, as were women's perceptions about the benefits of micronutrient supplements to their health and that of their newborns.
  
  
  CONCLUSIONS
  Malian women adhere to prenatal/postpartum micronutrient supplementation - no matter what supplement is chosen - when access to supplements is guaranteed and when they are provided with minimum, consistent and easily understandable information and counselling, indicating that these are key elements to ensure effective programmes. These findings, together with those of the global research agenda on the efficacy of multiple micronutrient supplements for pregnant women, will inform policy development in Mali for the effective control of iron deficiency and iron-deficiency anaemia in pregnant women.
authors.affiliation: UNICEF Regional Office for West and Central Africa, Dakar-Yoff, Senegal. vaguayo@unicef.org
authors.forename: Víctor M
authors.initials: VM
authors.lastname: Aguayo
authors.forename: Diakalia
authors.initials: D
authors.lastname: Koné
authors.forename: Sory Ibrahim
authors.initials: SI
authors.lastname: Bamba
authors.forename: Baba
authors.initials: B
authors.lastname: Diallo
authors.forename: Yacouba
authors.initials: Y
authors.lastname: Sidibé
authors.forename: Diakalia
authors.initials: D
authors.lastname: Traoré
authors.forename: Pierre
authors.initials: P
authors.lastname: Signé
authors.forename: Shawn K
authors.initials: SK
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000517:prevention & control*; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D005494:Folic Acid Deficiency / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D007501:Iron / Q000008:administration & dosage; D000090463:Iron Deficiencies; D007774:Lactation / Q000187:drug effects / Q000502:physiology*; D008302:Mali; D018977:Micronutrients / Q000008:administration & dosage / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D049590:Postpartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care
chemical_list: D018977:Micronutrients; D005492:Folic Acid; D007501:Iron