IJOMAHIP Published Article Details

Abstract Background. Anemia in pregnancy remains a major public health problem, affecting an estimated 37% of pregnant women worldwide in 2019. Daily iron-folic acid (IFA) supplementation is standard antenatal care, yet anemia persists among rural Filipino women. Moringa oleifera is locally abundant and has been proposed as an adjunct, but Philippine evidence is limited. Objective. To determine whether adjunct M. oleifera supplementation can be delivered, adhered to, accepted and tolerated within routine antenatal care, and to generate preliminary estimates of change in hemoglobin, weight and mid-upper arm circumference (MUAC). Methods. An open-label, pilot two-arm parallel randomized controlled trial with an embedded qualitative component enrolled 20 pregnant women in two barangays of Sindangan, Zamboanga del Norte, allocated 1:1 to routine IFA alone (Group A) or IFA plus a 500 mg M. oleifera capsule daily (Group B) for 90 days. Adherence, acceptability, and safety were assessed through journals, a Likert-scale questionnaire, and monthly monitoring; hemoglobin, weight, and MUAC were measured at baseline and monthly. Results. All 20 women received their allocated regimen. Paired hemoglobin data were available for 7 of 10 participants in Group A and 8 of 10 in Group B. Mean adherence was 99.4% (SD 1.6) in Group A and 99.3% (SD 1.0) in Group B; acceptability was 5.00 and 4.96 of 5.00, respectively. No serious adverse events occurred. Hemoglobin rose in both arms (Group A +1.38 g/dL; Group B +1.07 g/dL), with no significant between-group difference (0.31 g/dL, 95% CI −1.24 to 1.86; p = .674). Retrospective power was approximately 7%. Conclusion. Adjunct M. oleifera supplementation was feasible, well adhered to, highly acceptable, and tolerated in routine rural antenatal care. The trial was not powered to establish efficacy, and the confidence intervals could not exclude a meaningful benefit or harm. A definitive trial of approximately 148 women per arm would be needed to detect a 0.5 g/dL hemoglobin difference; until then, routine IFA supplementation should remain the primary intervention, with M. oleifera considered a promising, locally available complement rather than a replacement. Keywords: acceptability; adherence; anemia; hemoglobin; iron-folic acid supplementation; Moringa oleifera; pilot randomized controlled trial; pregnancy