Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali

Abstract Mali national policy recommends that women take iron and folic acid supplements (IFA) from the time of the first antenatal care (ANC) visit, throughout pregnancy and during the first 3 months after delivery. In 2020, the World Health Organization (WHO) updated their ANC guidelines to recomm...

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Main Authors: Aissata Ba, Monica J. Fox, Adama Mamby Keita, Kristen M. Hurley, Shannon E. King, Samba Sow, Kounandji Diarra, Mahamane Djiteye, Baba Seydou Kanté, Moussa Coulibaly, Ousmane Dembele, Lisa M. Noguchi, Pooja Sripad, Peter J. Winch
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Maternal and Child Nutrition
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Online Access:https://doi.org/10.1111/mcn.13712
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author Aissata Ba
Monica J. Fox
Adama Mamby Keita
Kristen M. Hurley
Shannon E. King
Samba Sow
Kounandji Diarra
Mahamane Djiteye
Baba Seydou Kanté
Moussa Coulibaly
Ousmane Dembele
Lisa M. Noguchi
Pooja Sripad
Peter J. Winch
author_facet Aissata Ba
Monica J. Fox
Adama Mamby Keita
Kristen M. Hurley
Shannon E. King
Samba Sow
Kounandji Diarra
Mahamane Djiteye
Baba Seydou Kanté
Moussa Coulibaly
Ousmane Dembele
Lisa M. Noguchi
Pooja Sripad
Peter J. Winch
author_sort Aissata Ba
collection DOAJ
description Abstract Mali national policy recommends that women take iron and folic acid supplements (IFA) from the time of the first antenatal care (ANC) visit, throughout pregnancy and during the first 3 months after delivery. In 2020, the World Health Organization (WHO) updated their ANC guidelines to recommend the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) formulation of multiple micronutrient supplements (MMS) in the context of rigorous research, including implementation research. In Bamako, Mali, a codesign process was used to tailor antenatal care MMS packaging and counselling materials aimed at optimizing delivery and uptake of and adherence to MMS. This paper presents the codesign process along with the results of a post‐intervention qualitative assessment to evaluate the behaviour change intervention. At the conclusion of the intervention, we conducted semistructured qualitative interviews with 24 women who had received the intervention and six pharmacy managers from the six health centres participating in the study. We conducted two focus groups with midwives who had delivered the intervention and two group discussions with family members of women who had received the intervention. Respondent perspectives reveal an easy experience transitioning from previously used IFA. Women and providers concur that the intervention counselling materials and visual aids were instrumental in influencing the perceived benefit and uptake of MMS. Family members play an influential role in pregnant women's decision‐making regarding MMS uptake. MMS and the associated implementation strategies developed through the codesign process were found to be a highly acceptable intervention.
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spelling doaj-art-786d3691d5a245c4a1eaedbc394b62d22025-08-20T02:36:45ZengWileyMaternal and Child Nutrition1740-86951740-87092025-01-01211n/an/a10.1111/mcn.13712Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, MaliAissata Ba0Monica J. Fox1Adama Mamby Keita2Kristen M. Hurley3Shannon E. King4Samba Sow5Kounandji Diarra6Mahamane Djiteye7Baba Seydou Kanté8Moussa Coulibaly9Ousmane Dembele10Lisa M. Noguchi11Pooja Sripad12Peter J. Winch13Jhpiego Bamako MaliDepartment of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USACenter for Vaccine Development Bamako MaliDepartment of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USADepartment of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USACenter for Vaccine Development Bamako MaliCenter for Vaccine Development Bamako MaliCenter for Vaccine Development Bamako MaliCenter for Vaccine Development Bamako MaliCenter for Vaccine Development Bamako MaliCenter for Vaccine Development Bamako MaliJhpiego Baltimore Maryland USAJhpiego Baltimore Maryland USADepartment of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USAAbstract Mali national policy recommends that women take iron and folic acid supplements (IFA) from the time of the first antenatal care (ANC) visit, throughout pregnancy and during the first 3 months after delivery. In 2020, the World Health Organization (WHO) updated their ANC guidelines to recommend the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) formulation of multiple micronutrient supplements (MMS) in the context of rigorous research, including implementation research. In Bamako, Mali, a codesign process was used to tailor antenatal care MMS packaging and counselling materials aimed at optimizing delivery and uptake of and adherence to MMS. This paper presents the codesign process along with the results of a post‐intervention qualitative assessment to evaluate the behaviour change intervention. At the conclusion of the intervention, we conducted semistructured qualitative interviews with 24 women who had received the intervention and six pharmacy managers from the six health centres participating in the study. We conducted two focus groups with midwives who had delivered the intervention and two group discussions with family members of women who had received the intervention. Respondent perspectives reveal an easy experience transitioning from previously used IFA. Women and providers concur that the intervention counselling materials and visual aids were instrumental in influencing the perceived benefit and uptake of MMS. Family members play an influential role in pregnant women's decision‐making regarding MMS uptake. MMS and the associated implementation strategies developed through the codesign process were found to be a highly acceptable intervention.https://doi.org/10.1111/mcn.13712adherenceantenatal carecounsellingiron and folic acidMalimultiple micronutrient supplementation
spellingShingle Aissata Ba
Monica J. Fox
Adama Mamby Keita
Kristen M. Hurley
Shannon E. King
Samba Sow
Kounandji Diarra
Mahamane Djiteye
Baba Seydou Kanté
Moussa Coulibaly
Ousmane Dembele
Lisa M. Noguchi
Pooja Sripad
Peter J. Winch
Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
Maternal and Child Nutrition
adherence
antenatal care
counselling
iron and folic acid
Mali
multiple micronutrient supplementation
title Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
title_full Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
title_fullStr Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
title_full_unstemmed Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
title_short Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
title_sort qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation mms for pregnant women in bamako mali
topic adherence
antenatal care
counselling
iron and folic acid
Mali
multiple micronutrient supplementation
url https://doi.org/10.1111/mcn.13712
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