Evidence map›Paper›PMID 34038529›Full record

Trial reportThe Journal of nutrition2021

Strengthening Nutrition Interventions in Antenatal Care Services Affects Dietary Intake, Micronutrient Intake, Gestational Weight Gain, and Breastfeeding in Uttar Pradesh, India: Results of a Cluster-Randomized Program Evaluation.

Phuong H Nguyen, Shivani Kachwaha, Lan M Tran, Rasmi Avula, Melissa F Young, Sebanti Ghosh, Praveen K Sharma, Jessica Escobar-Alegria, Thomas Forissier, Sumeet Patil and 2 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The Journal of nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03378141 (Evaluate a Feasibility Study of Integrating Maternal Nutrition Interventions in Existing Reproductive, Maternal, Newborn and Child Health Services in Uttar Pradesh, India), which is not on this map. Cited by 33 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 4 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03378141 nacompletednot on this map

Evaluate a Feasibility Study of Integrating Maternal Nutrition Interventions in Existing Reproductive, Maternal, Newborn and Child Health Services in Uttar Pradesh, India

TypeinterventionalSponsorInternational Food Policy Research InstituteRan2017 to 2020Enrolled8,000ConditionsAnemia, Undernutrition, Underweight, StuntingArmsMaternal Nutrition Behavior change
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 82 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Phuong H NguyenInternational Food Policy Research Institute, Washington, DC, USA.ORCID 0000-0003-3418-1674
Shivani KachwahaInternational Food Policy Research Institute, Washington, DC, USA.
Lan M TranFHI Solutions, Washington, DC, USA.
Rasmi AvulaInternational Food Policy Research Institute, Washington, DC, USA.
Melissa F YoungHubert Department of Global Health, Emory University, Atlanta, GA, USA.
Sebanti GhoshFHI Solutions, Washington, DC, USA.
Praveen K SharmaFHI Solutions, Washington, DC, USA.
Jessica Escobar-AlegriaFHI Solutions, Washington, DC, USA.
Thomas ForissierFHI Solutions, Washington, DC, USA.
Sumeet PatilNetwork for Engineering, Economics, Research and Management (NEERMAN), Delhi, India.
Edward A FrongilloHealth Department of Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.ORCID 0000-0002-8265-9815
Purnima MenonInternational Food Policy Research Institute, Washington, DC, USA.ORCID 0000-0001-5988-2894
Family Health International 360 · USInternational Food Policy Research Institute · USEmory University · USUniversity of South Carolina · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaternal nutrition interventions are inadequately integrated into antenatal care (ANC). Alive & Thrive aimed to strengthen delivery of micronutrient supplements and intensify interpersonal counseling and community mobilization through government ANC services.

objectivesWe compared nutrition-intensified ANC (I-ANC) with standard ANC (S-ANC) on coverage of nutrition interventions and maternal nutrition practices.

methodsWe used a cluster-randomized design with cross-sectional baseline (2017) and endline (2019) surveys (n ∼660 pregnant and 1800 recently delivered women per survey) and a repeated-measures longitudinal study in 2018-2019 (n = 400). We derived difference-in-difference effect estimates (DIDs) for diet diversity, consumption of micronutrient supplements, weight monitoring, and early breastfeeding practices.

resultsDespite substantial secular improvements in service coverage from India's national nutrition program, women in the I-ANC arm received more home visits [DID: 7-14 percentage points (pp)] and counseling on core nutrition messages (DID: 10-23 pp) than in the S-ANC arm. One-third of women got ≥3 home visits and one-fourth received ≥4 ANC check-ups in the I-ANC arm. Improvements were greater in the I-ANC arm than in the S-ANC arm for any receipt and consumption of iron-folic acid (DID: 7.5 pp and 9.5 pp, respectively) and calcium supplements (DID: 14.1 pp and 11.5 pp, respectively). Exclusive breastfeeding improved (DID: 7.5 pp) but early initiation of breastfeeding did not. Maternal food group consumption (∼4 food groups) and probability of adequacy of micronutrients (∼20%) remained low in both arms. Repeated-measures longitudinal analyses showed similar results, with additional impact on consumption of vitamin A-rich foods (10 pp, 11 g/d), other vegetables and fruits (22-29 g/d), and gestational weight gain (0.4 kg).

conclusionsIntensifying nutrition in government ANC services improved maternal nutrition practices even with strong secular trends in service coverage. Dietary diversity, supplement consumption, and breastfeeding practices remained suboptimal. Achieving greater behavior changes will require strengthening the delivery and use of maternal nutrition services integrated into ANC services in the health system. This trial was registered at clinicaltrials.gov as NCT03378141.

Indexed as

Breast FeedingGestational Weight GainCross-Sectional StudiesEatingFemaleHumansIndiaLongitudinal StudiesPregnancyPrenatal CareProgram Evaluationbreastfeedingdiet qualityIndiainterpersonal counselingmaternal nutritionmicronutrient intake

Identifiers

PMID34038529
PMCPMC8349122
OpenAlexW3164483617

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.