The Need Of Implementing An Integrated Approach For The Primary Prevention Of Neural Tube Defects And Orofacial Clefts In D.R. Congo: Challenges And Opportunities

Research Article
Tshienda M. Denon,AhukaOna longombe, Mathe Elise, Kahindo Katsongeri and Paluku Mukongoma
Folates supplementation, pregnant women, neural tubes defects, orofacial clefts and curve of ALDEN

The DR Congo is facing a great challenge in the implementation of folates supplementation among pregnant women for preventing anemia during pregnancy and congenital malformations, such as neural tube defects and orofacial clefts. Indeed, 58.5 % of pregnant women are illiterate or with low level of literacy. The comparison between the instruction level and pregnancy planning demonstrated that there is a strong dependence of the instruction level on the pregnancy planning. This is graphically described as the curve of ALDEN Several feeding diets among pregnant women are lacking in folates and others vitamins. The vast majority of pregnant women are fed by available diets in 72.5% despite their increased needs in folates and others vitamins. Few pregnant women (9.2%) are attending antenatal care before the first trimester. However, the vast majority of pregnant women are attending antenatal care services later in 71.61%. The vast majority of women are getting pregnant without family planning in 82.0%. Moreover, this study demonstrated clearly that vitamins supplementation is facing several challenges as follow: the insufficient level of instruction, lack of family planning, the delay to attend antenatal care service, inadequacy between evidence-based data and the actual supplementation DR Congolese programme and lack of integrated approach in the supplementation programme. The results might offer more opportunities in primary prevention for sensitization of attending antenatal care services utilization as soon as possible, for strengthening the family planning programme, implementing preconceptional vitamins supplementation and the need of an integrated approach for the primary prevention of congenital malformations.