Adherence Partners are an Acceptable Intervention to Support Adherence to Prenatal Micronutrient Supplementation among Pregnant Women in Western Kenya

In populations with low calcium (Ca) intake, WHO now recommends providing prenatal Ca supplementation alongside iron‐folic acid (IFA) as part of antenatal care (ANC) services to reduce maternal mortality. Even when pregnant women have a stable supply of supplements, they often cite forgetting and family disapproval as adherence barriers. Adherence partners (AP) are a behavior change intervention that expands social support to improve adherence. Pregnant women select APs from their social network (e.g., a spouse or relative) and ask APs to encourage and remind them to take their supplements. This study assessed the acceptability of APs to improve adherence to prenatal Ca and IFA supplements in western Kenya through trials of improved practices, a formative research methodology that follows participants over time as they try a new behavior. We collected qualitative and quantitative data on acceptability and adherence during 3 interviews over 6 weeks. We provided 33 pregnant women with Ca and IFA supplements, counseling, and calendars, and then offered the option of selecting an AP; 26 women agreed to try an AP. Although many women in our previous formative research described husbands as unhelpful during pregnancy, 16 of 26 women selected their husbands to be their AP; most others chose female relatives. Participants reported APs supported adherence by encouraging, reminding, bringing supplements, and providing food. AP support of prenatal Ca and IFA supplements could be acceptable and helpful for pregnant women in low‐resource settings, even in the context of limited family support and ANC attendance. Further research is warranted to assess the appropriateness, feasibility, and impact of this low‐cost intervention.