Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review
Objectives Daily calcium supplements are recommended for pregnant women from 20 weeks’ gestation to prevent pre-eclampsia in populations with low dietary calcium intake. We aimed to improve understanding of barriers and facilitators for calcium supplement intake during pregnancy to prevent pre-eclam...
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e070677.full |
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| author | Taryn Young Ana Pilar Betran Hema Mistry Richard Riley Shakila Thangaratinam Guillermo Carroli Edgardo Abalos Zahida P Qureshi John Allotey Anna Thorson Meghan A Bohren Rana Islamiah Zahroh G Justus Hofmeyr Juan Pablo Peña-Rosas Alfredo Palacios Thaís Rocha Joshua Peter Vogel Luc Smits Gabriela Cormick Koiwah Koi Larbi Kym IE Snell Hellen Moraa George N Gwako |
| author_facet | Taryn Young Ana Pilar Betran Hema Mistry Richard Riley Shakila Thangaratinam Guillermo Carroli Edgardo Abalos Zahida P Qureshi John Allotey Anna Thorson Meghan A Bohren Rana Islamiah Zahroh G Justus Hofmeyr Juan Pablo Peña-Rosas Alfredo Palacios Thaís Rocha Joshua Peter Vogel Luc Smits Gabriela Cormick Koiwah Koi Larbi Kym IE Snell Hellen Moraa George N Gwako |
| author_sort | Taryn Young |
| collection | DOAJ |
| description | Objectives Daily calcium supplements are recommended for pregnant women from 20 weeks’ gestation to prevent pre-eclampsia in populations with low dietary calcium intake. We aimed to improve understanding of barriers and facilitators for calcium supplement intake during pregnancy to prevent pre-eclampsia.Design Mixed-method systematic review, with confidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations-Confidence in the Evidence from Reviews of Qualitative research approach.Data sources MEDLINE and EMBASE (via Ovid), CINAHL and Global Health (via EBSCO) and grey literature databases were searched up to 17 September 2022.Eligibility criteria We included primary qualitative, quantitative and mixed-methods studies reporting implementation or use of calcium supplements during pregnancy, excluding calcium fortification and non-primary studies. No restrictions were imposed on settings, language or publication date.Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias. We analysed the qualitative data using thematic synthesis, and quantitative findings were thematically mapped to qualitative findings. We then mapped the results to behavioural change frameworks to identify barriers and facilitators.Results Eighteen reports from nine studies were included in this review. Women reported barriers to consuming calcium supplements included limited knowledge about calcium supplements and pre-eclampsia, fears and experiences of side effects, varying preferences for tablets, dosing, working schedules, being away from home and taking other supplements. Receiving information regarding pre-eclampsia and safety of calcium supplement use from reliable sources, alternative dosing options, supplement reminders, early antenatal care, free supplements and support from families and communities were reported as facilitators. Healthcare providers felt that consistent messaging about benefits and risks of calcium, training, and ensuring adequate staffing and calcium supply is available would be able to help them in promoting calcium.Conclusion Relevant stakeholders should consider the identified barriers and facilitators when formulating interventions and policies on calcium supplement use. These review findings can inform implementation to ensure effective and equitable provision and scale-up of calcium interventions.PROSPERO registration number CRD42021239143. |
| format | Article |
| id | doaj-art-c95c1aa7f85a495695e93e393217f5e7 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-c95c1aa7f85a495695e93e393217f5e72025-08-20T03:52:29ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2022-070677Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic reviewTaryn Young0Ana Pilar Betran1Hema Mistry2Richard Riley3Shakila Thangaratinam4Guillermo Carroli5Edgardo Abalos6Zahida P Qureshi7John Allotey8Anna Thorson9Meghan A Bohren10Rana Islamiah Zahroh11G Justus Hofmeyr12Juan Pablo Peña-Rosas13Alfredo Palacios14Thaís Rocha15Joshua Peter Vogel16Luc Smits17Gabriela Cormick18Koiwah Koi Larbi19Kym IE Snell20Hellen Moraa21George N Gwako22Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa2 UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland1 Warwick Clinical Trials Unit, University of Warwick, Coventry, UK3 NIHR Birmingham Biomedical Research Centre, Birmingham, England, UK18 University of Birmingham Institute of Metabolism and Systems Research, Birmingham, UKCentro Rosarino de Estudios Perinatales (CREP), Rosario, Santa Fe, ArgentinaCentro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina40 University of Nairobi Department of Obstetrics and Gynecology, Nairobi, Kenya15 NIHR Birmingham Biomedical Centre (BRC), University Hospitals Birmingham, Birmingham, UK1 UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), WHO, Geneva, SwitzerlandCentre for Health Equity, University of Melbourne School of Population and Global Health, Melbourne, Victoria, AustraliaGender and Women`s Health Unit, Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia21 Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, BotswanaDepartment of Nutrition and Food Safety, World Health Organization, Geneve, SwitzerlandCentre for Health Economics, University of York, York, UKWHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UKMaternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, AustraliaDepartment of Epidemiology, Care, and Public Health Research Institute, Maastricht University, Maastricht, NetherlandsCentro de Investigaciones en Epidemiología y Salud Pública (Consejo Nacional de Investigaciones Científicas y Técnicas- CONICET), Instituto de Efectividad Clinica y Sanitaria, Buenos Aires, ArgentinaAction on Preeclampsia (APEC), Accra, Ghanaassociate professorUniversity of Nairobi, Nairobi, KenyaUniversity of Nairobi, Nairobi, KenyaObjectives Daily calcium supplements are recommended for pregnant women from 20 weeks’ gestation to prevent pre-eclampsia in populations with low dietary calcium intake. We aimed to improve understanding of barriers and facilitators for calcium supplement intake during pregnancy to prevent pre-eclampsia.Design Mixed-method systematic review, with confidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations-Confidence in the Evidence from Reviews of Qualitative research approach.Data sources MEDLINE and EMBASE (via Ovid), CINAHL and Global Health (via EBSCO) and grey literature databases were searched up to 17 September 2022.Eligibility criteria We included primary qualitative, quantitative and mixed-methods studies reporting implementation or use of calcium supplements during pregnancy, excluding calcium fortification and non-primary studies. No restrictions were imposed on settings, language or publication date.Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias. We analysed the qualitative data using thematic synthesis, and quantitative findings were thematically mapped to qualitative findings. We then mapped the results to behavioural change frameworks to identify barriers and facilitators.Results Eighteen reports from nine studies were included in this review. Women reported barriers to consuming calcium supplements included limited knowledge about calcium supplements and pre-eclampsia, fears and experiences of side effects, varying preferences for tablets, dosing, working schedules, being away from home and taking other supplements. Receiving information regarding pre-eclampsia and safety of calcium supplement use from reliable sources, alternative dosing options, supplement reminders, early antenatal care, free supplements and support from families and communities were reported as facilitators. Healthcare providers felt that consistent messaging about benefits and risks of calcium, training, and ensuring adequate staffing and calcium supply is available would be able to help them in promoting calcium.Conclusion Relevant stakeholders should consider the identified barriers and facilitators when formulating interventions and policies on calcium supplement use. These review findings can inform implementation to ensure effective and equitable provision and scale-up of calcium interventions.PROSPERO registration number CRD42021239143.https://bmjopen.bmj.com/content/13/12/e070677.full |
| spellingShingle | Taryn Young Ana Pilar Betran Hema Mistry Richard Riley Shakila Thangaratinam Guillermo Carroli Edgardo Abalos Zahida P Qureshi John Allotey Anna Thorson Meghan A Bohren Rana Islamiah Zahroh G Justus Hofmeyr Juan Pablo Peña-Rosas Alfredo Palacios Thaís Rocha Joshua Peter Vogel Luc Smits Gabriela Cormick Koiwah Koi Larbi Kym IE Snell Hellen Moraa George N Gwako Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review BMJ Open |
| title | Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review |
| title_full | Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review |
| title_fullStr | Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review |
| title_full_unstemmed | Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review |
| title_short | Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review |
| title_sort | factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre eclampsia a mixed methods systematic review |
| url | https://bmjopen.bmj.com/content/13/12/e070677.full |
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