(P14-083-20) How Can We Improve the Measurement of Iron Folic Acid Coverage Globally? Key Findings from Recent Measurement Research

Objectives: Daily Iron-Folic Acid (IFA) supplementation is recommended for all pregnant women but there is no global standard coverage indicator. The validity of common IFA consumption indicators is questionable. The WHO UNICEF Technical Expert Advisory Group for Nutrition Monitoring and partners have supported multiple efforts to identify a feasible and valid indicator of IFA coverage for reporting by World Health Assembly member states.

Methods: In 2019 we conducted 1) key informant interviews (KII) in 8 countries 2) an online survey among 58 nutrition professionals from 31 countries 3) cognitive interviews with postpartum women in Senegal, Bangladesh and Nepal and 4) advanced analysis of determinants of IFA data quality across four Demographic and Health Surveys (DHS).  Together these methods characterized current challenges and identified ways to improve IFA coverage measurement.

Results: The KII and online surveys reported similar challenges.  Less than half (45%) of online survey respondents were satisfied with their current methods for collecting IFA coverage data. Recommended changes include reduced recall period, adding questions about counseling, including other beneficiary groups and assessing supply issues.  Cognitive interviews confirmed that women find it difficult to answer questions about numbers of pills consumed. Results from the DHS data quality analysis are forthcoming.

Conclusions: IFA coverage measurement is a global priority and there is clear demand for a revised indicator and guidance for collection in survey and administrative systems.  While indicators of IFA delivery are more feasible there are promising ways to improve women’s report of amount of IFA consumed.

Funding Sources: Bill & Melinda Gates Foundation