Prevention of Spina Bifida and Folic Acid Intake by Women in Northern Uganda

Abstract

Objectives: The intake of folic acid (FA) before conception and during the first trimester of pregnancy can prevent spina bifida (SB).  This paper describes FA intake in women in northern Uganda. Methods: 15 mothers of children with SB, 394 women attending antenatal clinics, and 35 health workers, working at antenatal clinics at government health facilities were interviewed. SPSS16 was used for data analysis. Results: A fourth of the mothers of children with SB took FA during late pregnancy, none took FA pre conception or in the first trimester. None had knowledge about FA and SB prevention. Of the women attending ANC 33.5% (132/394) had ever heard about SB, none knew FA could prevent SB. 51% took FA in late pregnancy, none preconception, 17.4% during first trimester. 3.0% said FA was not available. Women staying further from health facilities had a significant lower intake of FA compared to those staying nearby. All said to have eaten food rich in FA. None were aware about fortified foods, nor the importance of early FA intake. Only 6% of health workers understood the importance of early FA intake. All health workers recommended FA intake to women attending ANC. 20% of the health workers said FA supplements are not always available. Conclusions: FA intake is limited in northern Uganda. This is attributed to late presentation of women at ANC, poor supply chain, and limited understanding about the importance of early FA intake. A combined effort, including food fortification, sensitization of health workers, women, and improving FA supply is recommended.