Improving nutritional care in antenatal services for socio-economically vulnerable communities in Howrah District, West Bengal, India: a best practice implementation project

ABSTRACT Introduction: High-quality antenatal care, particularly the provision of iron and folic acid, calcium supplementation, deworming with albendazole, and weight management, are critical for the well-being of both mother and child. Adhering to nutritional guidelines plays an important role in reducing maternal anemia, preterm births, and low birth weight. Objectives: This evidence-based implementation project aimed to evaluate current antenatal care practices and enhance nutritional care in accordance with best practice recommendations, specifically targeting women in socio-economically vulnerable communities. Methods: This project followed JBI's seven-phase methodology for evidence implementation, employing audit and feedback with a structured framework to identify barriers, facilitators, and implementation strategies. It was carried out in two health and wellness sub-centers in Howrah district, West Bengal, India. Results: The project improved compliance with evidence-based nutritional recommendations, and pregnant women are now provided customized dietary guidelines based on their individual requirements in these marginalized communities. This was achieved through the collaboration of internal and external stakeholders who facilitated the implementation of co-designed strategies, as well as discussions with other key stakeholders and project champions. Improvements were made through training and empowering local health workers in giving pregnant women nutritional advice and by improving referral pathways. Conclusions: The findings of this study indicate that nutritional guidelines in pregnancy should consider regional dietary habits, economic constraints, and cultural beliefs and practices of specific communities. Customized antenatal care rather than a standardized approach to maternal nutrition may be of benefit in achieving desired outcomes. Spanish abstract: https://links.lww.com/IJEBH/A732