Scaling up the delivery and utilization of maternal nutrition interventions is a challenge in high burden countries. This paper examines the individual, family and health service factors influencing the utilization of maternal nutrition interventions in Bangladesh.
Household survey data among pregnant (n=600) and recently delivered women (n=2,000) were used. Multivariate linear and logistic regression analyses were conducted to examine the determinants of three outcomes: consumption of iron and folic acid (IFA) tablets, calcium tablets and diverse diets.
Women consumed 94 IFA and 82 calcium tablets during pregnancy, and half of them consumed an adequately diverse diet. High maternal nutrition knowledge was the key individual factor associated with higher consumption of IFA and calcium tablets (Ã_32) and diverse diet (OR =1.8), compared to low knowledge. Women’s self-efficacy and perception of enabling social norms were significantly associated with dietary diversity. At the family level, women who reported a high level of husband’s support were more likely to consume IFA (Ã=25) and calcium (Ã=27) tablets, and diverse diet (OR=1.94), compared to those who received low support. Health service factors associated with higher intakes of IFA and calcium tablets were early and more prenatal care visits, and free supplements. Combined exposure to several of these factors was attributed to the consumption of an additional 46 IFA, 53 calcium tablets and 17% diverse diets.
In order to improve utilization, maternal nutrition programs should focus on improving knowledge, self-efficacy and perceptions of social norms among pregnant women, and increasing husbands’ support, early registration in prenatal care, and provision of free IFA and calcium supplements.