社区批准对青春期前青少年每周补充铁和/或叶酸的依从性至关重要：布基纳法索农村地区的一项定性研究。
Community approval required for periconceptional adolescent adherence to weekly iron and/or folic acid supplementation: a qualitative study in rural Burkina Faso.
机构信息
Clinical Research Unit Nanoro, Institut de Recherche en Sciences de la, Santé, Direction Régionale du Centre-Ouest, Nanoro, Burkina Faso.
Department of Biomedical Sciences, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium.
出版信息
Reprod Health. 2018 Mar 14;15(1):48. doi: 10.1186/s12978-018-0490-y.
BACKGROUND
Iron deficiency remains a prevalent adolescent health problem in low income countries. Iron supplementation is recommended but improvement of iron status requires good adherence.
OBJECTIVES
We explored factors affecting adolescent adherence to weekly iron and/or folic acid supplements in a setting of low secondary school attendance.
METHODS
Taped in-depth interviews were conducted with participants in a randomised, controlled, periconceptional iron supplementation trial for young nulliparous women living in a rural, malaria endemic region of Burkina Faso. Participants with good, medium or poor adherence were selected. Interviews were transcribed and analysed thematically.
RESULTS
Thirty-nine interviews were conducted. The community initially thought supplements were contraceptives. The potential benefits of giving iron supplementation to unmarried "girls" ahead of pregnancy were not recognised. Trial participation, which required parental consent, remained high but was not openly admitted because iron supplements were thought to be contraceptives. Unmarried non-school attenders, being mobile, were often sent to provide domestic labour in varied locations. This interrupted adherence - as did movement of school girls during vacations and at marriage. Field workers tracked participants and trial provision of free treatment encouraged adherence. Most interviewees did not identify health benefits from taking supplements.
CONCLUSIONS
For success, communities must be convinced of the value of an adolescent intervention. During this safety trial, benefits not routinely available in iron supplementation programmes were important to this low income community, ensuring adolescent participation. Nevertheless, adolescents were obliged to fulfil cultural duties and roles that interfered with regular adherence to the iron supplementation regime.
TRIAL REGISTRATION
Trial Registration at clinicaltrials.gov : NCT01210040.
背景
缺铁仍然是低收入国家青少年普遍存在的健康问题。建议补充铁，但要改善铁的状态需要良好的依从性。
目的
我们在中学入学率较低的情况下，探讨了影响青少年每周服用铁和/或叶酸补充剂的因素。
方法
对居住在布基纳法索农村疟疾流行地区的年轻未婚初产妇参加的一项随机、对照、围孕期铁补充试验中的参与者进行了录音深入访谈。选择了依从性好、中等或差的参与者进行访谈。对访谈进行了转录和主题分析。
结果
共进行了 39 次访谈。社区最初认为补充剂是避孕药。人们没有认识到在怀孕前给未婚“女孩”补充铁的潜在好处。由于补充铁被认为是避孕药，需要父母同意的试验参与率仍然很高，但并没有公开承认。未婚非在校生流动性强，经常被派往不同地点提供家务劳动。这打断了他们的依从性——学校女生在假期和结婚期间的流动也是如此。现场工作人员跟踪参与者，免费提供治疗的试验规定鼓励了他们的依从性。大多数受访者没有从服用补充剂中识别出健康益处。
结论
为了成功，社区必须相信青少年干预的价值。在这个安全试验中，对这个低收入社区来说，铁补充计划中通常不可用的益处非常重要，这确保了青少年的参与。然而，青少年有义务履行文化职责和角色，这干扰了他们定期服用铁补充剂的规律。
试验注册
ClinicalTrials.gov 上的试验注册：NCT01210040。
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