title: Attitudes and practices towards micronutrient supplementation among pregnant women in rural Tibet.
abstract: The objective of this study was to identify trends and change in micronutrient supplementation (MNS) knowledge across pregnancy and post-partum and to assess the impact of MNS knowledge (MNS-k) on practice in pregnancy in rural Tibet, an area with endemic micronutrient deficiency. A prospective cohort with repeated measures at early, late and after pregnancy in a rural area in the Tibetan Autonomous Region included women receiving care by community workers. Key messages about MNS-k and optimal MNS practice were communicated through health worker encounters with pregnant women. Outcomes included MNS consumption practice, knowledge and attitudes. The proportion of women in the highest MNS-k category increased by 35% from early to late pregnancy (37.5-50.7%, respectively; p < .005). MNS-k was associated with MNS consumption in a dose-response manner over pregnancy (trend X2p-value < .0001), with increasing knowledge associated with increased MNS consumption. By late pregnancy, 32.5% of women had never consumed an MNS in this pregnancy, and 51.5% had not consumed an MNS on the assessed day or the day before. Sustained knowledge of MNS improved in pregnancy and post-partum. Best practice around MNS consumption increased though remained sub-optimal.
authors.affiliation: a Department of Obstetrics and Gynecology, School of Medicine and Dentistry , University of Rochester , Rochester , NY , USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: De Ver Dye
authors.forename: Gretel
authors.initials: G
authors.lastname: Pelto
authors.forename: Sibylle
authors.initials: S
authors.lastname: Kristensen
authors.forename: Arlene
authors.initials: A
authors.lastname: Samen
authors.forename: Ann
authors.initials: A
authors.lastname: Dozier
keywords: Tibet; maternal health; micronutrient; pregnancy; supplementation