Role of routine oral iron/folic acid supplementation during pregnancy on childhood mortality, stunting and birth weight/size in Nepal and Pakistan

Abstract

The aim of this body of research is to investigate the determinants of neonatal and under-five mortality and the role of antenatal iron/folic acid supplementation in preventing neonatal and under-five deaths. The specific aims include examining the associations between socio-economic and demographic factors and neonatal and under-five mortality, and the extent to which antenatal iron/folic acid supplementation is associated with improved neonatal and under-five survival in Nepal and Pakistan. This research used both quantitative and qualitative methods. For the quantitative analyses, data were derived from Nepal Demographic and Health Surveys (DHSs), Pakistan DHSs, and a district level household survey in Pakistan. The qualitative study was conducted in two districts of Pakistan and involved women and healthcare providers. The findings highlight the importance of antenatal iron/folic acid supplementation to prevent the risk of early neonatal, neonatal and under-five deaths in Pakistan and Nepal. Public health interventions such as health promotion programs, retraining of healthcare providers, strengthening the logistic system are required to increase the coverage of iron/folic acid supplementation. The findings support the early initiation of iron/folic acid supplements with continuation of supplements throughout pregnancy. Therefore, there is a need to revisit the current iron/folic acid supplementation programs in these countries.