{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:01:43Z","timestamp":1782316903480,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Nutrition International (formerly Micronutrient Initiative) through a grant from Global Affairs Canada"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Calcium (Ca) supplementation to prevent preeclampsia can save maternal and newborn lives, but there are no program models for integration into existing antenatal care platforms. We used a program impact pathway model to guide the design of integrated Ca and iron\u2013folate (IFA) supplementation in Kenya. We provided healthcare providers with job aids (posters and counseling cards), trained them on counseling techniques and supplementation guidelines, and developed behavior change materials for pregnant women (pill\u2010taking calendars). We allocated health facilities to prescribe either 1.0 or 1.5\u00a0g\/day Ca, with standard IFA. We collected implementation data from 16 facilities and 990 women. We also explored effects of supplementation on percentage of the population meeting recommended daily allowance. Supplements and job aids were available during 90% of facility spot\u2010check episodes; calendar availability was lower (78%). Over 98% of clients received Ca and IFA supplements, but only 76% received enough Ca supplements to last between antenatal care visits. Among clients that still had pills by return date, adherence was 77% and 83% for the IFA and Ca regimen, respectively. When 1.5\u00a0g\/day of Ca supplements were prescribed, over 75% of participants met recommended daily allowance. Only 54% met the recommended daily allowance when 1.0\u00a0g was prescribed. This study illustrates a systematic approach for integrating Ca supplementation into primary healthcare and demonstrates that such integration is feasible when contextual bottlenecks are addressed. Policy makers and program planners should pay attention to supply chain, healthcare worker dispensing behavior, and appropriateness of regimen for their settings.<\/jats:p>","DOI":"10.1111\/mcn.12437","type":"journal-article","created":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T11:00:22Z","timestamp":1519902022000},"source":"Crossref","is-referenced-by-count":24,"title":["Feasibility of integrating calcium and iron\u2013folate supplementation to prevent preeclampsia and anemia in pregnancy in primary healthcare facilities in Kenya"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5417-911X","authenticated-orcid":false,"given":"Moshood O.","family":"Omotayo","sequence":"first","affiliation":[{"name":"Program in International Nutrition Cornell University  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Dickin","sequence":"additional","affiliation":[{"name":"Program in International Nutrition Cornell University  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Program in International Nutrition Cornell University  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Martin","sequence":"additional","affiliation":[{"name":"Program in International Nutrition Cornell University  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline K.","family":"Kung'u","sequence":"additional","affiliation":[{"name":"Africa Regional Office \u2010 Nutrition International  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Stoltzfus","sequence":"additional","affiliation":[{"name":"Program in International Nutrition Cornell University  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-206"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu7031744"},{"key":"e_1_2_10_4_1","unstructured":"Dickin K. Griffiths M. Piwoz E.G. (n.d.).Designing by dialogue: A program planners' guide to consultative research for improving young child feeding; Academy for Educational Development: Washington DC USA 1997. \u2010 Open Access Library. Retrieved March 29 2016 fromhttp:\/\/www.oalib.com\/references\/9079992"},{"key":"e_1_2_10_5_1","volume-title":"Guideline: Calcium Supplementation in Pregnant Women. (2013). Guideline: Calcium Supplementation in Pregnant Women","author":"Glanz K.","year":"2008"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.113.004689"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_8_1","first-page":"CD001059","article-title":"Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems","volume":"6","author":"Hofmeyr G. J.","year":"2014","journal-title":"The Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_9_1","unstructured":"Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium Ross C. Taylor C. L. Yaktine A. L. Del Valle H. B. 2011 National Academies Press (US) Washington (DC)"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2015.11.002"},{"key":"e_1_2_10_11_1","unstructured":"Kenya National Micronutrient Survey 2011. (2016).Report on the dietary data of the Kenya National Micronutrient Survey 2011 Ch. 10. file:\/\/\/S:\/windows\/Kenya%20National%20Micronutrient%20Survey%20Report%202011%20Final.pdf. Accessed on 12\/08\/16"},{"key":"e_1_2_10_12_1","unstructured":"Kim S. Habicht J.\u2010P. Menon P. &Stoltzfus R.(2011).How do programs work to improve child nutrition?\u00a0:: IFPRI Publications. Retrieved March 29 2016 fromhttp:\/\/ebrary.ifpri.org\/cdm\/ref\/collection\/p15738coll2\/id\/124932"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12233"},{"key":"e_1_2_10_14_1","unstructured":"Martin S. L. Birhanu Z. Omotayo M. O. Kebede Y. Pelto G. H. Stoltzfus R. J. &Dickin K. L.(2017b).Measuring social support for adherence to prenatal micronutrient supplementation in Ethiopia and Kenya: Contextual adaptation of the cognitive interviewing Process.Field Methods."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ716"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10464-012-9521-y"},{"key":"e_1_2_10_17_1","article-title":"Calcium supplementation to prevent preeclampsia: Translating guidelines into practice in low\u2010income countries","author":"Omotayo M.","year":"2016","journal-title":"Advances in Nutrition"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-16-00054"},{"key":"e_1_2_10_19_1","volume-title":"Integrating strategies for prevention of preeclampsia and anemia in pregnancy into primary healthcare delivery in Kenya","author":"Omotayo M. O.","year":"2016"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.4081\/jphr.2015.582"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.117.251926"},{"key":"e_1_2_10_22_1","first-page":"e12521","article-title":"With adaptation, the WHO guidelines on calcium supplementation for prevention of preeclampsia are adopted by pregnant women","author":"Omotayo M. O.","year":"2017","journal-title":"Maternal & Child Nutrition"},{"key":"e_1_2_10_23_1","unstructured":"Palacios C. &Pena\u2010Rosas J.(n.d.).Guideline: Daily iron and folic acid supplementation in pregnant women."},{"key":"e_1_2_10_24_1","unstructured":"StataCorp.2015.Stata statistical software: Release 14. College Station TX: StataCorp LP. (n.d.). Retrieved March 29 2016 fromhttp:\/\/www.stata.com\/support\/faqs\/resources\/citing\u2010software\u2010documentation\u2010faqs\/"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.110.128793"},{"key":"e_1_2_10_26_1","unstructured":"World Health OrganizationGuideline: Calcium Supplementation in Pregnant Women. (2013).Guideline: Calcium Supplementation in Pregnant Women. World Health Organization. Retrieved fromhttp:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24006556January 28th 2017."}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fmcn.12437","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.12437","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T16:50:10Z","timestamp":1695660610000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.12437"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2]]},"references-count":25,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/mcn.12437"],"URL":"https:\/\/doi.org\/10.1111\/mcn.12437","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2]]},"article-number":"e12437"}}