Effectiveness of an iron supplementation programme for pregnant and postpartum women in rural Bangladesh

Abstract

Objective: Compare the levels of anaemia in a population served by an iron supplementation programme with that in other rural populations in Bangladesh: Methodology: Haemoglobin concentration was determined from a venous sample of blood using the HemoCue system for women during the postpartum period. Two hundred twenty women who delivered between June and August 1994 were examined: half of them at 2 weeks and 6 months after delivery, and the other half at 3 months and 9 months postpartum (mean of two values are presented). The Matlab MCH-FP intervenlion programme has been distributing iron/folic acid tablets to all pregnant and lactating women since 1974. Compliance was tested using a questionnaire. Laboratory results were compared with: (i) historical data: haematocrit levels taken in Matlab in 1975 from 2,445 women (converted to estimate haemoglobin levels by 0.33); and (ii) contemporary data: haemoglobin surveys conducted by the International Food Policy Research Institute (IFPRI) in 1996 from non-pregnant married women aged less than 50 years using the HemoCue method. Criteria for non-anaemia in non-pregnant women was 12 g/dl Hb. Results: The mean Hb levels (95% confidence interval; percentage below 12.0 g/dl) were as follows: (1) Matlab 1994: 12.9 (12.7-13.1) g/dl (23%); (2) Matlab 1975: 11.7 (11.7-11.8) g/dl, (60%); (3) IFPRI Manikganj: 12.0(11.8-12.1)(47%); (4)IFPRI Mymensingh: 11.3(11.1-11.5),59%; (5)IFPRI Jessore: 11.9 (11.8-12.1), 44%. There were no significant differences in height and weight among the study populations. The Matlab 1994 had a significantly higher proportion of women aged less than 30 years. Compliance with iron/folic acid in this population was very high. The iron/folic acid distribution programme may have had an impact varying between 47 and 61 % of reduction in the prevalence of anaemia, with an increase of 0.9 to 2.1 g/dl Hb concentration. Conclusion: The low postpartum anaemia levels may be associated with an intensive iron/folic acid supplementation programme in Matlab