The World Health Organization (WHO) now recommends prenatal calcium supplementation for prevention of preeclampsia in populations with inadequate dietary intake. This study seeks to compare the effect of two dosing strategies on the amount of supplement ingested by pregnant women and adherence to related recommendations.
This study is a non-inferiority trial that compares the effect of a dosing strategy involving lower overall dose and fewer administrations per day to the current WHO recommendation. The comparator arm, Regimen B, prescribes 3 doses per day (consistent with current WHO standard) and was found to be burdensome in qualitative studies. The experimental arm, Regimen A, prescribes 2 doses per day and has been associated with greater satisfaction. On face value Regimen A should result in 33% less amount of supplement ingested than Regimen B. However, we hypothesize that the difference in amount ingested, when rolled out in routine practice will be MUCH LESS than that BECAUSE THE LOWER DOSE REGIMEN RESULTS IN HIGHER LEVELS OF ADHERENCE. We hypothesize that THE DIFFERENCE IN AMOUNT CONSUMED WILL BE NEGLIGIBLE OR will not exceed 15%. Hence, we hypothesize that Regimen A is not inferior to Regimen B in terms of total amount of supplement ingested (within a 15% margin of inferiority).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
1,032
Comparison of recommended administration schedule for calcium and iron/folic acid supplements in pregnant women
Comparison of recommended administration schedule for calcium and iron/folic acid supplements in pregnant women
Chebwayi Health centre
Kakamega, Kenya
Chegulo Health centre
Kakamega, Kenya
Chevoso Health centre
Kakamega, Kenya
Amount of calcium supplement ingested
This is the actual number of supplements ingested expressed as a percentage of the number of supplements expected to be ingested since the ANC consultation if 100% adherent to the current WHO recommendation. \[Total number of calcium supplements consumed/(Number of days since last ANC consultation X 3)\] X 100
Time frame: 8 weeks after ANC consultation, during which recruitment into the study occurred
Adherence to related recommendations
Adherence to other features of the WHO recommendation (taking supplements with food).
Time frame: 8 weeks after ANC consultation, during which recruitment into the study occurred
Motivation
Motivation scores extracted from the survey instrument administered at follow up.
Time frame: 8 weeks after ANC consultation, during which recruitment into the study occurred
Self-efficacy
Self-efficacy scores extracted from the survey instrument administered at follow up.
Time frame: 8 weeks after ANC consultation, during which recruitment into the study occurred
Satisfaction
Satisfaction scores extracted from the survey instrument administered at follow up.
Time frame: 8 weeks after ANC consultation, during which recruitment into the study occurred
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