Influence of Directly Observed Iron Therapy on Adherence to Iron Tablets Consumption by Pregnant Women in A Rural Field Practice Area” -A Controlled Trial

Abstract

Background and objectives: ABSTRACT Iron deficiency is the most prevalent nutritional deficiency on the globe. Women, especially during pregnancy, are among those most vulnerable population to iron deficiency and its more severe manifestation, anaemia. Many pregnant women have very less compliance to oral iron tablets prescribed. To achieve higher compliance in this regard, there is a need to concentrate on a better way of delivery system. Appointing a direct observer from the community itself may be a cost- effective way of finding a solution to this problem. Current study was undertaken to validate a method for monitoring and delivery of iron supplements to the pregnant women by direct observers, in order to evaluate the adherence to the supplement regimen and observe the possible effects on haemoglobin values. Methodology: The study was conducted between January 2008 to December 2008 in villages belonging to Agasaga and Shivapur subcentres of Handignur PHC, a rural field practice area of J N Medical College, Belgaum. A total of 140 pregnant women were recruited for a non-randomised controlled trial, who were studied under the case and control groups. Direct observers were assigned to the case group, for monitoring consumption by the pregnant women. Detailed history and baseline investigations were done before the initiation of study, followed by a total of four visits to each participant. IX Results: The possible confounding factors ( demographic variables, baseline investigations, etc ) were matched across cases and controls. The mean adherence rate and haemoglobin levels in case group entailed a statistically significant outcome ( p=0.000) compared to the Control group across all visits. Conclusion: It was observed that assigning a direct observer for monitoring and delivery of iron supplementation, amplifies the adherence of pregnant women to oral iron tablets.