Effect of Personalized Support at Home on the Prevalence of Anemia in Pregnancy in Burkina Faso: A Cluster Randomized Trial

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  • 1 Centre Muraz, Institut National de Santé Publique, Bobo-Dioulasso, Burkina Faso;
  • 2 Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso;
  • 3 Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium

Burkina Faso has high prevalence of anemia in pregnancy (hemoglobin < 11 g/dL), despite the implementation of the WHO recommended guidelines. This study aimed to test the effects of personalized support for pregnant women at home on the trend of anemia prevalence in pregnancy. A cluster randomized trial was conducted from January 2015 to August 2016 at Sindou health district in Burkina Faso. Data were collected from 617 women in their first or second trimester of pregnancy, including 440 and 177 women in the intervention and control groups, respectively. The intervention consisted of a monthly home-based visit to the pregnant woman, focusing on nutritional counseling and pregnancy management, alongside an improvement antenatal visit quality. Compared with the prevalence of anemia in pregnancy in the control group [64.0% (95% confidence interval [CI]: 52.1–74.4%)], that of the intervention group was significantly lower from the fifth home visit onward [36.8% (95% CI: 32.1–41.8%)] (P < 0.001). The adjusted difference-in-differences in anemia prevalence between the two groups was –19.8% (95% CI: –30.2% to –9.4%) for women who received more than four home visits (P < 0.001). The corresponding difference in hemoglobin levels was 0.644 g/dL (95% CI: 0.309–0.167; P < 0.001). Personalized support for pregnant women at home, combined with appropriate antenatal care, can significantly reduce anemia prevalence during pregnancy in rural Burkina Faso.

Author Notes

Address correspondence to Bernard Ilboudo, Centre Muraz, Institut National de Santé Publique, Avenue Mamadou Konaté, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso 01. E-mail: bernard.ilboudo@ulb.be

Financial support: This study was supported by the CUD (now ARES) of the Kingdom of Belgium for the follow-up of pregnant women and data collection.

Authors’ addresses: Bernard Ilboudo, Centre Muraz, Institut National de Santé Publique, Bobo-Dioulasso, Burkina Faso, and Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium, E-mail: bernard.ilboudo@ulb.be. Léon G. B. Savadogo, Isidore Traoré, Clément Z. Méda, Maurice Kinda, and Issiaka Sombié, Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso, E-mails: gueswende@hotmail.com, tiandiogo2002@yahoo.fr, medacle1@yahoo.fr, mmkinda@yahoo.fr, and sombie_issiaka@yahoo.com. Michèle Dramaix-Wilmet and Philippe Donnen, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium, E-mails: miwilmet@ulb.ac.be and philippe.donnen@ulb.be.

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