Search results for: Celeste Labuschagne

Authors: Celeste Labuschagne, Sam Ramaila, Thasmai Dhurumraj

Abstract:

Although formative assessment is acknowledged as crucial for teachers to gauge students’ understanding of subject content, applying formative assessment in an online context is more challenging than in a traditional Physical Sciences classroom. This study examines challenges experienced by Grade 10 Physical Sciences teachers when enacting online formative assessment. The empirical investigation adopted a generic qualitative design and involved three purposively selected Grade 10 Physical Sciences teachers from three different schools and quintiles within the Tshwane North District in South Africa. Data were collected through individual and focus group interviews. Technological, pedagogical, and content knowledge (TPACK) was utilised as a theoretical framework underpinning the study. The study identified a myriad of challenges experienced by Grade 10 Physical Sciences teachers when enacting online formative assessment. These challenges include the utilisation of Annual Teaching Plans, lack of technological knowledge, and internet connectivity. The Department of Basic Education faces the key imperative to provide continuous teacher professional development and concomitant online learning materials that can facilitate meaningful enactment of online formative assessment in various educational settings.

Keywords: COVID-19, challenges, online formative assessment, physical sciences, TPACK

Procedia PDF Downloads 36

Authors: Vittoria Franchina, Laura Salerno, Rubinia Celeste Bonfanti, Gianluca Lo Coco

Abstract:

This study examines the relationships between existential concerns (ECs), basic psychological needs (BPNs), vaccine hesitancy (VH), and the mediating role of negative attitudes toward COVID-19 vaccines. A cross-sectional survey was carried out on a sample of two-hundred eighty-seven adults (Mage = 36.04 (12.07); 59.9% females). Participants were recruited online through clickworker and filled in measures on existential concerns, basic psychological needs, attitudes toward COVID-19 vaccines, and vaccine hesitancy for Pfizer-BioNTech and Astrazeneca vaccines separately. Structural equation modelling showed that existential concerns were related to Pfizer-BioNTech and Astrazeneca vaccine hesitancy both directly and indirectly through negative attitudes toward possible side effects of COVID-19 vaccines. The present study has identified several predictive factors relating to the intention to uptake vaccination to protect against COVID-19 in Italy. Specifically, these findings suggest a causal link between existential concerns, attitudes, and vaccine hesitancy.

Keywords: COVID-19, existential concerns, Pfizer-BioNTech and Astrazeneca vaccines, vaccine hesitancy

Procedia PDF Downloads 66

Authors: Francesco Buccafurri, Celeste Romolo

Abstract:

Nowadays phishing is the most frequent starting point of cyber-attack vectors. Phishing is implemented both via email and social network messages. While a wide scientific literature exists which addresses the problem of contrasting email spam-phishing, no specific countermeasure has been so far proposed for phishing included into private messages of social network platforms. Unfortunately, the problem is severe. This paper proposes an approach against social network phishing, based on a non invasive collaborative information-sharing approach which leverages blockchain. The detection method works by filtering candidate messages, by distilling them by means of a distance-preserving hash function, and by publishing hashes over a public blockchain through a trusted smart contract (thus avoiding denial of service attacks). Phishing detection exploits social information embedded into social network profiles to identify similar messages belonging to disjoint contexts. The main contribution of the paper is to introduce a new approach to contrasting the problem of social network phishing, which, despite its severity, received little attention by both research and industry.

Keywords: phishing, social networks, information sharing, blockchain

Procedia PDF Downloads 291

Authors: William Brasier, Nicolas Rabin, Celeste Joly

Abstract:

Japanese knotweed (Fallopia japonica) is very present on the banks of the Rhone, colonizing more and more areas along the river. The Compagnie Nationale du Rhone (C.N.R.), which manages the river, has experimented with several control techniques in recent years. Since 2015, 15 experimental plots have been monitored on the banks of a restored river appendix to measure the effect of three control methods: confinement by felt, repeated mowing and the planting of competing species and/or species with allelopathic power: Viburnum opulus, Rhamnus frangula, Sambucus ebulus and Juglans regia. Each year, the number of stems, the number of elderberry plants, the height of the plants and photographs were collected. After six years of monitoring, the results showed that the density of knotweed stems decreased by 50 to 90% on all plots. The control methods are sustainable and are gradually gaining in efficiency. The establishment of native plants coupled with regular manual maintenance can reduce the development of Japanese knotweed. Continued monitoring over the next few years will determine the kinetics of the total eradication (i.e. 0 stem/plot) of the Japanese knotweed by these methods.

Keywords: fallopia japonica, interspecific plant competition , Rhone river, riparian trees

Procedia PDF Downloads 102

Authors: E. Kempen, M. J. Labuschagne, M. P. Jama

Abstract:

There is evidence that experiential learning is truly influential and favored by the millennial generation. However, little is known about the role and attributes an educator has to adopt during the experiential learning cycle, especially when applied in optometry education. This study aimed to identify the roles and attributes of an optometry educator during the different modes of the experiential learning cycle. Methods: A qualitative case study design was used. Data was collected using an open-ended questionnaire survey, following the application of nine different teaching-learning methods based on the experimental learning cycle. The total sample population of 68 undergraduate students from the Department of Optometry at the University of the Free State, South Africa were invited to participate. Focus group interviews (n=15) added additional data that contributed to the interpretation and confirmation of the data obtained from the questionnaire surveys. Results: The perceptions and experiences of the students identified a variety of roles and attributes as well as recommendations on the effective adoption of these roles and attributes. These roles and attributes included being knowledgeable, creating an interest, providing guidance, being approachable, building confidence, implementing ground rules, leading by example, and acting as a mediator. Conclusion: The findings suggest that the actions of an educator have the most substantial impact on students’ perception of a learning experience. Not only are the recommendations based on the views of a millennial generation, but the implementation of the personalized recommendations may also transform a learning environment. This may lead an optometry student to a deeper understanding of knowledge.

Keywords: experiences and perceptions, experiential learning, millennial generation, recommendation for optometry education

Procedia PDF Downloads 83

Authors: M. Ntswane, N. Mbuma, M. Labuschagne, A. Mofokeng, M. Rantso

Abstract:

Cowpea is an essential legume for the nutrition and health of millions of people in different regions. The production and productivity of the crop are very limited in South Africa due to a lack of adapted and stable genotypes. The improvement of nutritional quality is made possible by manipulating the genes of diverse cowpea genotypes available around the world. Assessing the adaptability and stability of the cowpea mutant genotypes for yield and nutritional quality requires examining them in different environments. The objective of the study was to determine the adaptability and stability of cowpea mutant genotypes under South African conditions and to identify the superior genotypes that combine grain yield components, antioxidants, and nutritional quality. Thirty-one cowpea genotypes were obtained from the Agricultural Research Council grain crops (ARC-GC) and were planted in Glen, Mafikeng, Polokwane, Potchefstroom, Taung, and Vaalharts during the 2021/22 summer cropping season. Significant genotype by location interactions indicated the possibility of genetic improvement of these traits. The genotype plus genotype by environment indicated broad adaptability and stability of mutant genotypes. The principal component analysis identified the association of the genotypes with the traits. Phenotypic correlation analysis showed that Zn and protein content were significant and positively correlated and suggested the possibility of indirect selection of these traits. Results from this study could be used to help plant breeders in making informed decisions and developing nutritionally improved cowpea genotypes with the aim of addressing the challenges of poor nutritional quality.

Keywords: cowpea seeds, adaptability, stability, mineral elements, protein content

Procedia PDF Downloads 77

Authors: E. Kempen, M. J. Labuschagne, M. P. Jama

Abstract:

There is evidence that any learning experience should happen in a safe learning environment as students then will interact, experiment, and construct new knowledge. However, little is known about the specific elements required to create a safe learning environment for the millennial generation, especially in optometry education. This study aimed to identify the specific elements that will contribute to a safe learning environment for the millennial generation of optometry students. Methods: An intrinsic qualitative case study was undertaken with undergraduate students from the Department of Optometry at the University of the Free State, South Africa. An open-ended questionnaire survey was completed after the application of nine different teaching-learning methods based on the experiential learning cycle. A total number of 307 questionnaires were analyzed. Two focus group interviews were also conducted to provide additional data to supplement the data and ensure the triangulation of data. Results: Important elements based on the opinions, feelings, and perceptions of student respondents were analyzed. Students feel safe in an environment with which they are familiar, and when they are familiar with each other, the educators, and the surroundings. Small-group learning also creates a safe and familiar environment. Both these elements create an environment where they feel safe to ask questions. Students value an environment where they are able to learn without influencing their marks or disadvantaging the patients. They enjoy learning from their peers, but also need personal contact with educators. Elements such as consistency and an achievable objective also were also analyzed. Conclusion: The findings suggest that to respond to the real need of this generation of students, insight must be gained in students’ perceptions to identify their needs and the learning environment to optimize learning pedagogies. With the implementation of these personalized elements, optometry students will be able to take responsibility and accountability for their learning.

Keywords: experiences and perceptions, safe learning environment, millennial generation, recommendation for optometry education

Procedia PDF Downloads 113

Authors: Leticia Souza Guirra, Márcia Eduarda Vieira Ramos, Edlaine Souza Pereira, Leticia Correa Celeste

Abstract:

Introduction: Studies indicate that equine-assisted therapy enables improvements in several areas of functioning that are impaired in children with autism spectrum disorder (ASD), such as social interaction and communication. Objective: The study proposes to analyze the development of dialogic skills of a verbal child with ASD after participating in the equine-assisted therapy Step By Step in Communication. Method: This is quantitative and qualitative research through a case study. It refers to a 6 years old child diagnosed with ASD belonging to a group of practitioners of the Brazilian National Equine-Assited-Therapy Association. The Behavioral Observation Protocol (PROC) was used to evaluate communicative skills before and after the intervention, which consisted of 24 sessions once a week. Results: All conversational skills increased their frequency, with participation in dialogue and initiation of interaction. The child also increases the habit of waiting for his turn and answering the interlocutor. The emission of topics not related to conversation and echolalia showed a significant decrease after the intervention. Conclusion: The studied child showed improvement in communicative skills after participating in the equine-assisted therapy Step By Step in Communication. Contributions: This study contributes to a greater understanding of the impact of equine-assisted therapy on the communicative abilities of children with ASD.

Keywords: equine-assisted-therapy, autism spectrum disorder, language, communication, language and hearing sciences

Procedia PDF Downloads 49

Authors: Naznine Anwar, Kim Cornish, Izelle Labuschagne, Nellie Georgiou-Karistianis

Abstract:

Falls and subsequent injuries are common features in symptomatic Huntington’s disease (symp-HD) individuals. As part of daily walking, navigating around obstacles may incur a greater risk of falls in symp-HD. We designed obstacle-crossing experiment to examine adaptive gait dynamics and to identify underlying spatiotemporal gait characteristics that could increase the risk of falling in symp-HD. This experiment involved navigating around one or two ground-based obstacles under two conditions (walking while navigating around one obstacle, and walking while navigating around two obstacles). A total of 32 participants were included, 16 symp-HD and 16 healthy controls with age and sex matched. We used a GAITRite electronic walkway to examine the spatiotemporal gait characteristics and inter-trail gait variability when participants walked at their preferable speed. A minimum of six trials were completed which were performed for baseline free walk and also for each and every condition during navigating around the obstacles. For analysis, we separated all walking steps into three phases as approach steps, navigating steps and recovery steps. The mean and inter-trail variability (within participant standard deviation) for each step gait variable was calculated across the six trails. We found symp-HD individuals significantly decreased their gait velocity and step length and increased step duration variability during the navigating steps and recovery steps compared with approach steps. In contrast, HC individuals showed less difference in gait velocity, step time and step length variability from baseline in both respective conditions as well as all three approaches. These findings indicate that increasing spatiotemporal gait variability may be a possible compensatory strategy that is adopted by symp-HD individuals to effectively navigate obstacles during walking. Such findings may offer benefit to clinicians in the development of strategies for HD individuals to improve functional outcomes in the home and hospital based rehabilitation program.

Keywords: Huntington’s disease, gait variables, navigating around obstacle, basal ganglia dysfunction

Procedia PDF Downloads 417

Authors: Domenica Tambasco, Riina Bray, Sophia Jaworski, Gillian Grant, Celeste Corkery

Abstract:

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and reduced function. Management of symptoms include medications, physical treatments and mindfulness therapies. Myofascial Release is a modality that has been successfully applied in var-ious musculoskeletal conditions. However, to the author’s best knowledge, it is not yet recog-nized as a self-management therapy option in Fibromyalgia. In this study, we investigated whether Self-applied Myofascial Release (SMR) is associated with overall improved function and symptoms in Fibromyalgia. Methods: Eligible adult patients with a confirmed diagnosis of Fibromyalgia at Women’s College Hospital were recruited to SMR. Sessions ran for 1 hour once a week for 7 weeks, led by the same two Physiotherapists knowledgeable in this physical treat-ment modality. The main outcome measure was an overall impact score for function and symp-toms based on the validated assessment tool for Fibromyalgia, the Revised Fibromyalgia Impact Questionnaire (FIQR), measured pre and post-intervention. Both descriptive and analytical methods were applied and reported. Results: We analyzed results using a paired t-test to deter-mine if there was a statistically significant difference in mean FIQR scores between initial (pre-intervention) and final (post-intervention) scores. A clinically significant difference in FIQR was defined as a reduction in score by 10 or more points. Conclusions: Our pilot study showed that SMR appeared to be a safe and effective intervention for our Fibromyalgia participants and the overall impact on function and symptoms occurred in only 7 weeks. Further studies with larger sample sizes comparing SMR to other physical treatment modalities (such as stretching) in an RCT are recommended.

Keywords: fibromyalgia, myofascial release, physical therapy, FIQR

Procedia PDF Downloads 52

Authors: Celeste De Kock, Bruce Anderson, Corneile Minnaar

Abstract:

Geographic variation in the floral morphology of a flower species has often been assumed to result from co-variation in the availability of regionally-specific functional pollinator types, giving rise to plant ecotypes that are adapted to the morphology of the main pollinator types in that area. Wachendorfia paniculata is a geographically variable enantiostylous (handed) flower with preliminary observations suggesting that differences in pollinator community composition might be driving differences in the degree of herkogamy (spatial separation of the stigma and anthers on the same flower) across its geographic range. This study aimed to determine if pollinator-related variables such as visitation rate and pollinator type could explain differences in floral morphology seen in different populations. To assess pollinator community compositions, pollinator visitation rates, and the degree of herkogamy and flower size, flowers from 13 populations were observed and measured across the Western Cape, South Africa. Multiple regression analyses indicated that pollinator-related variables had no significant effect on the degree of herkogamy between sites. However, the degree of herkogamy was strongly negatively associated with the time of measurement. It remains possible that pollinators have had an effect on the development of herkogamy throughout the evolutionary timeline of different W. paniculata populations, but not necessarily to the fine-scale degree, as was predicted for this study. Annual fluctuations in pollinator community composition, paired with recent disturbances such as urbanization and the overabundance of artificially introduced honeybee hives, might also result in the signal of pollinator adaptation getting lost. Surprisingly, differences in herkogamy between populations could largely be explained by the time of day at which flowers were measured, suggesting a significant narrowing of the distance between reproductive parts throughout the day. We propose that this floral movement could possibly be an adaptation to ensure pollination if pollinator visitation to a flower was not sufficient earlier in the day, and will be explored in subsequent studies.

Keywords: enantiostyly, floral movement, geographic variation, ecotypes

Procedia PDF Downloads 246

Authors: Celeste Lawson

Abstract:

Learning to embrace and value teamwork assessment at a university level is critical for students, as graduates enter a real-world working environment where teamwork is likely to occur virtually. Student disdain for teamwork exercises is an area often overlooked or disregarded by academics. This research explored the implementation of an online teamwork assessment approach at a regional Australian university with a significant cohort of Distance Education students. Students had disliked teamwork for three reasons: it was not relevant to their study, the grading was unfair amongst team members, and managing the task was challenging in a virtual environment. Teamwork assessment was modified so that the task was an authentic task that could occur in real-world practice; team selection was based on the task topic rather than randomly; grading was based on the individual’s contribution to the task, and students were provided virtual team management skills as part of a the assessment. In this way, management of the team became an output of the task itself. Data was gathered over three years from student satisfaction surveys, failure rates, attrition figures, and unsolicited student comments. In one unit where this approach was adopted (Advanced Public Relations), student satisfaction increased from 3.6 (out of 5) in 2012 to 4.6 in 2016, with positive comments made about the teamwork approach. The attrition rate for another unit (Public Relations and the Media) reduced from 20.7% in 2012 to 2.2% in 2015. In 2012, criticism of teamwork assessment made up 50% of negative student feedback in Public Relations and the Media. By 2015, following the successful implementation of the teamwork assessment approach, only 12.5% of negative comments on the student satisfaction survey were critical of teamwork, while 33% of positive comments related to a positive teamwork experience. In 2016, students explicitly nominated teamwork as the best part of this unit. The approach is transferable to other disciplines and was adopted by other academics within the institution with similar results.

Keywords: assessment, distance education, teamwork, virtual

Procedia PDF Downloads 113

Authors: Flackson Tshuma, James Bennett, Pieter Andreas Swanepoel, Johan Labuschagne, Stephan van der Westhuizen, Francis Rayns

Abstract:

Amongst other things, tillage and synthetic agrochemicals can be effective methods of seedbed preparation and pest control. Nonetheless, frequent and intensive tillage and excessive application of synthetic agrochemicals, such as herbicides and insecticides, can reduce soil microbial enzyme activity. A decline in soil microbial enzyme activity can negatively affect nutrient cycling and crop productivity. In this study, the effects of four tillage treatments; continuous mouldboard plough; shallow tine-tillage to a depth of about 75 mm; no-tillage; and tillage rotation (involving shallow tine-tillage once every four years in rotation with three years of no-tillage), and two rates of synthetic agrochemicals (standard: with regular application of synthetic agrochemicals; and reduced: fewer synthetic agrochemicals in combination with bio-chemicals/ or bio-stimulants) on soil microbial enzyme activity were investigated between 2018 and 2020 in a typical Mediterranean climate zone in South Africa. Four different bio-stimulants applied contained: Trichoderma asperellum, fulvic acid, silicic acid, and Nereocystis luetkeana extracts, respectively. The study was laid out as a complete randomised block design with four replicated blocks. Each block had 14 plots, and each plot measured 50 m x 6 m. The study aimed to assess the combined impact of tillage practices and reduced rates of synthetic agrochemical application on soil microbial enzyme activity in a dryland cropping system. It was hypothesised that the application of bio-stimulants in combination with minimum soil disturbance will lead to a greater increase in microbial enzyme activity than the effect of applying either in isolation. Six soil cores were randomly and aseptically collected from each plot for microbial enzyme activity analysis from the 0-150 mm layer of a field trial under a dryland crop rotation system in the Swartland region. The activities of four microbial enzymes, β-glucosidase, acid phosphatase, alkaline phosphatase and urease, were assessed. The enzymes are essential for the cycling of glucose, phosphorus, and nitrogen, respectively. Microbial enzyme activity generally increased with a reduction of both tillage intensity and synthetic agrochemical application. The use of the mouldboard plough led to the least (P<0.05) microbial enzyme activity relative to the reduced tillage treatments, whereas the system with bio-stimulants (reduced synthetic agrochemicals) led to the highest (P<0.05) microbial enzyme activity relative to the standard systems. The application of bio-stimulants in combination with reduced tillage, particularly no-tillage, could be beneficial for enzyme activity in a dryland farming system.

Keywords: bio-stimulants, soil microbial enzymes, synthetic agrochemicals, tillage

Procedia PDF Downloads 39

Authors: Rozelle Labuschagne, Ronel Roos

Abstract:

Individuals often experience a reduction in physical function, quality of life and basic activities of daily living after surgery. This is exponentially true for high-risk patients, especially the elderly and frail individuals. Not much is known about the physical function, physical activity preferences and factors associated with the six-minute walk test of elderly individuals who would undergo elective abdominal surgery in South Africa. Such information is important to design effective prehabilitation physiotherapy programs prior to elective surgery. The purpose of the study was to describe the demographic profile and physical function of elderly patients who would undergo elective surgery and to determine factors associated with their six-minute walk test distance findings. A cross-sectional descriptive study in elderly patients older than 60 years of age who would undergo elective abdominal surgery were consecutively sampled at a private hospital in Pretoria, South Africa. Participants’ demographics were collected and physical function assessed with the Functional Comorbidity Index (FCI), DeMorton Mobility Index (DEMMI), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) and six-minute walk test (6MWT). Descriptive and inferential statistics were used for data analysis with IBM SPSS 25. A p-value ≤ 0.05 were deemed statistically significant. The pilot study consisted of 12 participants (female (n=11, 91.7%), male (n=1, 8.3%) with a mean age of 65.8 (±4.5) years, body mass index of 28 (±4.2) kg.m2 with one (8.3%) participant being a current smoker and four (33.3%) participants having a smoking history. Nine (75%) participants lived independently at home and three (25%) had caregivers. Participants reported walking (n=6, 50%), stretching exercises (n=1, 8.3%), household chores & gardening (n=2, 16.7%), biking/swimming/running (n=1, 8.3%) as physical activity preferences. Physical function findings of the sample were: mean FCI score 3 (±1.1), DEMMI score 81.1 (±14.9), IADL 95 (±17.3), 6MWT 435.50 (IQR 364.75-458.50) with percentage 6MWT distance achieved 81.8% (IQR 64.4%-87.5%). A strong negative correlation was observed between 6MWT distance walked and FCI (r = -0.729, p=0.007). The majority of study participants reported incorporating some form of physical activity into their daily life as form of exercise. Most participants did not achieve their predicted 6MWT distance indicating less than optimal levels of physical function capacity. The number of comorbidities as determined by the FCI was associated with the distance that participants could walk with the 6MWT. The results of this pilot study could be used to indicate which elderly individuals would benefit most from a pre-surgical rehabilitation program. The main goal of such a program would be to improve physical function capacity as measured by the 6MWT. Surgeons could refer patients based on age and number of comorbidities, as determined by the FCI, to potentially improve surgical outcomes.

Keywords: abdominal surgery, elderly, physical function, six-minute walk test

Procedia PDF Downloads 170

Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers

Abstract:

Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.

Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands

Procedia PDF Downloads 202

Authors: Alexis D'Agostino, Celeste Sununtunasuk, Jack Fiedler

Abstract:

Background: Iron-folic acid (IFA) supplementation during antenatal care (ANC) has existed in many countries for decades. Despite this, low national coverage persists and women do not often consume appropriate amounts during pregnancy. USAID’s SPRING Project investigated pregnant women’s access to, and consumption of, IFA tablets through ANC. Cross-country analysis provided a global picture of the state of IFA-supplementation, while country-specific results noted key contextual issues, including geography, wealth, and ANC attendance. The analysis can help countries prioritize strategies for systematic performance improvements within one of the most common micronutrient supplementation programs aimed at reducing maternal anemia. Methodology: Using falter point analysis on Demographic and Health Survey (DHS) data collected from 162,958 women across 22 countries, SPRING identified four sequential falter points (ANC attendance, IFA receipt or purchase, IFA consumption, and number of tablets taken) where pregnant women fell out of the IFA distribution structure. SPRING analyzed data on IFA intake from DHS surveys with women of reproductive age. SPRING disaggregated these data by ANC participation during the most recent pregnancy, residency, and women’s socio-economic status. Results: Average sufficient IFA tablet use across all countries was only eight percent. Even in the best performing countries, only about one-third of pregnant women consumed 180 or more IFA tablets during their most recent pregnancy. ANC attendance was an important falter point for a quarter of women across all countries (with highest falter rates in Democratic Republic of the Congo, Nigeria, and Niger). Further analysis reveals patterns, with some countries having high ANC coverage but low IFA provision during ANC (DRC and Haiti), others having high ANC coverage and IFA provision but few women taking any tablets (Nigeria and Liberia), and countries that perform well in ANC, supplies, and initial consumption but where very few women consume the recommended 180 tablets (Malawi and Cambodia). Country-level analysis identifies further patterns of supplementation. In Indonesia, for example, only 62% of women in the poorest quintile took even one IFA tablet, while 86% of the wealthiest women did. This association between socioeconomic status and IFA intake held across nearly all countries where these data are available and was also visible in rural/urban comparisons. Analysis of ANC attendance data also suggests that higher numbers of ANC visits are associated with higher tablet intake. Conclusions: While it is difficult to disentangle which specific aspects of supply or demand cause the low rates of consumption, this tool allows policy-makers to identify major bottlenecks to scaling-up IFA supplementation during ANC. In turn, each falter point provides possible explanations of program performance and helps strategically identify areas for improved IFA supplementation. For example, improving the delivery of IFA supplementation in Ethiopia relies on increasing access to ANC, but also on identifying and addressing program gaps in IFA supply management and health workers’ practices in order to provide quality ANC services. While every country requires a customized approach to improving IFA supplementation, the multi-country analysis conducted by SPRING is a helpful first step in identifying country bottlenecks and prioritizing interventions.

Keywords: iron and folic acid, supplementation, antenatal care, micronutrient

Procedia PDF Downloads 365