Assessing Consumption of Folic Acid Fortified Staples and Associated Factors for Consumption among Women of Reproductive Age in Kisumu East District, Kenya, 2016

  • Maternal and child health
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Background: Inadequate preconception intake of the micronutrient folic acid (FA) can lead to anemia in pregnancy and neural tube defects (NTDs). Kenya has fortified staple foods with FA since 2012, but extent of consumption of these is unknown.

Methods: We conducted a population-based, cross-sectional study among reproductive-age women in Kisumu. Using multistage sampling, interviewers administered semi-structured questionnaires to gather information on demographics, knowledge of FA/food fortification and benefits, and FA-fortified staple consumption. Using Epi-Info, logistic regression modeling was conducted to examine factors associated with FA consumption.

Results: We enrolled 743 women (median age 27 years; range 15–49). Although 86% knew about FA, only 6% knew FA’s benefits for NTD prevention. Overall knowledge on food fortification was 45%, 31% knew staples were fortified with FA in Kenya, and 19% identified Kenya’s food fortification logo. The main information source about FA was healthcare providers (77%). Majority of the respondents (73%) reported consuming FA-fortified staples ≥2–3 times a week. The most commonly consumed FA-fortified staple was wheat flour at 68% and 43% consumed fortified maize flour. FA-fortified staple consumption was associated with counselling on importance of consuming FA-fortified staples (adjusted odds ratio (aOR) 4.4, 1.8–10.5); receiving information about FA preconceptionally (aOR 3.3, 1.3–8.7); knowledge of FA-fortified staples in Kenya (aOR 2.8, 1.6–5.1); and knowledge of the preconception benefits of FA (aOR 2.5, 1.5–4.2).

Conclusion: Consumption of FA-fortified staples was high despite low appreciation of NTD prevention, thus underscoring the importance of a national fortification strategy. We strongly recommend inclusion of other commonly used staples in the national fortification plan and further educating the population about the benefits of FA to improve coverage of at-risk groups and help prevent severe Neural Tube Defects.

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