In low-income countries where oral vaccine efficacy remains low, it has been hypothesized that poor prenatal nutrition may impair infant immune development and inhibit vaccine response in early life. The ROSE Nutrition Immunogenecity study was designed to evaluate the effect of prenatal supplementation on infant immune response to an oral rotavirus vaccine in Niger. Since 2015, 3000 women have been randomly assigned to receive 1 of 3 prenatal supplements: iron-folic acid tablets (IFA), multiple micronutrient capsules (MMN), or lipid-based nutrient supplements (LNS).This study aims to1)assess acceptability and utilization of IFA, MMN, and LNS over the course of pregnancy and 2) describe factors influencing acceptability and utilization by supplement type.
This longitudinal, qualitative study is being conducted in rural Niger using a triangulation of methods over 6 months. A criterion-based, stratified purposive sampling approach is being taken to recruit pregnant women (by gestational age: 20 wks and 20 wks), household and community influencers, and health staff for in-depth interviews (n= 100), focus group discussions (n= 20), and household observations (n= 90). Data will be collected until saturation of theme. Analysis using Dedoose software will draw from Grounded Theory and Qualitative Comparative Analysis approaches.
We will present an in-depth assessment comparing acceptability and utilization of IFA, MMN, and LNS over the course of pregnancy and influencing factors by behavioral level of the socio-ecological model.
Findings of supplement acceptability and utilization will be used to inform trial results and further prenatal supplement use in this setting.