| Summary: | Background
A
formative study was conducted at governmental antenatal clinics serving
low-income women in Mumbai, India to measure the association of tobacco use
with iron deficiency anemia, consumption of iron-rich foods and household food
insecurity; and to identify opportunities to integrate tobacco cessation
services with existing antenatal care for iron deficiency and anemia control.
Methods
We
administered a structured questionnaire to a sample of 100 pregnant patients at
5 governmental antenatal care clinics that serve low-income communities. Blood tests
were done for serum cotinine, hemoglobin and ferritin. We also conducted 10 key
informant interviews with physicians and auxiliary nurse midwives, and 5 focus
group discussions with community health workers to better understand the services
offered during antenatal clinic and home visits.
Results
Blood
test revealed that 16%, 72% and 41% of women used tobacco, were anemic and had iron
deficiency anemia (IDA), respectively. Tobacco use was independently associated
with IDA (OR=14.3; 95%CI=2.6, 77.9).
Tobacco use and IDA were not associated with household food insecurity. Clinics
had a system for screening and follow-up care for anemia and iron-deficiency,
but not for tobacco use. Antenatal care providers were interested in including
services to screen for tobacco use and provide cessation guidance. Patients
wanted help to quit.
Conclusions
It may be worthwhile
to assess the feasibility of integrating tobacco use screening and cessation services
with antenatal services for anemia and iron deficiency at governmental clinics
serving low-income populations in India.
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