Women’s Knowledge and Perception about Benefits of Folic Acid Intake Before & During Pregnancy According to Health Belief Model in Beni-Suief City

Research Abstract

Summary Over the past 5 decades, there has been a rapid growth of knowledge about FA and its role in the prevention of NTDs. (Bastian, 2008). Nowadays, folic acid deficiency is one of the most common vitamin deficiencies among women. The different NTDs types, including spina bifida, anencephaly and encephalocele lead to lifelong disability and premature death. Neural tube defects are caused by the failure of the open neural tube to close by the 29th day post-conception. In order to prevent these defects, a daily supplement of 0.4mg FA is recommended from a month before conception to the end of first trimester (Allen, 2006). The aim of the present study is to assess women’s knowledge and perception regarding benefits of FA intake before and during pregnancy according to the HBM. The study was conducted in antenatal care units which affiliates to 5 settings in Beni-Sueif city. Total number of 500 pregnant women was included in the study after receiving their written consents for participation. Method of data collection was a semi structured interview questionnaire which was designed by the researcher after reviewing the literature and researches which were relevant to the present study. This questionnaire consisted of different groups of questions to assess women’s knowledge regarding benefits of FA intake before and during pregnancy. The questions covered the main points about folate and health, and women perceptions related to FA -taking behavior according to the HBM. [[ [ The main findings of this study were: 1. Near half of the studied women (48.6%) were in age group ranging from 25-34 years and their mean age was (26.115 ± 5.515), while 65% had no consanguity with their husbands, while 39.4% of them had secondary education. Also 77% were lived in rural area, almost (93.4%) of them were house wife, and more than half of women (59.2%) were of extended family type. 2. The prevalence of women knowledge about FA intake were low just 19.6% had adequate knowledge about FA. 3. In relation to knowledge of FA benefits, approximately one third (32%) didn't know anything about FA benefits, and only 23.4% mentioned that FA decrease the risk of NTDs. 4. Regarding to description of FA, one quarter (28.4%) don't know it, while 20.8% of women described FA as a dietary supplement, while only 17.2% described it as a dietary supplement to prevent birth defects. 5. The present study showed that two thirds (68%) of women reported taking multivitamins during previous pregnancy, more than three quarters (82.3 %) of them reported taking supplements containing FA, and 90.1% took it during pregnancy. 6. Concerning to FA intake during current pregnancy, more than two thirds (70.8%) of women took FA currently, almost (95.8%) took it during pregnancy, while 79.1% took it in 1st trimester. and 82.4% of them took the recommended dose. While 56 of 146 of the studied women who reported non- intake of FA as they need prescription in order to take it. 7. The present study revealed that of the great majority of women who took FA during current pregnancy only 3.6% of them took it preconception and at early pregnancy as they lacked detailed knowledge about it as "only 18.6% of them reported NTDs as main complications associated with its deficiency, while only 16% of them reported preconception and at early pregnancy as the proper time of intake, and 53.7% of them didn't know other ways to get it. 8. When refer to compliance of FA; about 226 of the studied women who reported intake of FA were compliant to its intake. 9. The present study revealed that the great majority (89.8%) of the studied women had intention to follow a high folate diet. More than three quarters (84%) of women had positive perception related to FA -taking behavior according to the HBM. 10. The present study showed that 79.6% of the 358 women who described FA have learned about FA from their physicians. In conclusion, women knowledge about FA intake were low, also there were statistical significant differences between socio-demographic characteristics of the studied women and their knowledge as secondary education, planned pregnancy, and rural residence. Few percent of them had general knowledge that FA decrease the risk of NTDs, more than two thirds of women take FA currently, and almost of them had positive perception of FA. Secondary education and rural residence were statistically significant independent factors affecting women perception. Also more than three quarters of the women who reported FA intake, had positive perception. It is recommended to implement special measures as; a) develop Health education program should be developed for the population based on its cultural and socio-economic characteristics. This intervention could be as simple as providing information on the benefits of FA supplementation using all available mass media as (posters, magazine, and brochure for secondary schools); b) establishment of nutrition curricula for physicians and dieticians; c)implementing a continuing educational program for women including counseling skills about importance of FA before and during pregnancy; d) folic acid-containing oral contraceptives must be available in our countries to bridge the gap between the recognition of a pregnancy and closure of the neural tube; and e) raise the public awareness of national efforts for fortifications and identifying barriers of less consumption of fortified foods. Application of HBM to improve women& health care provider about perception related to FA intake benefits.

Research Keywords

Folic acid- neural tube defects -health belief model.