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In the past few months, the Shoklo Malaria Research Unit (SMRU) has begun a campaign to make pregnant Karen women and their husbands aware of the importance of pre-conceptual folate to prevent neural tube defects in newborns.

Composite photos of SMRU researcher meeting with local people, with a poster

In the past few months, the Shoklo Malaria Research Unit (SMRU) has begun a campaign to make pregnant Karen women and their husbands aware of the importance of pre-conceptual folate to prevent neural tube defects (NTD) in newborns. NTDs are a severe problem in the Thai-Myanmar border areas served by SMRU, with 12 NTD babies per 10,000 births – nearly 10 times higher than in the USA (1.1 per 10,000) and over five times higher than a recent survey from southern Thailand (1.88 per 10,000 births).

To raise awareness among border communities, Andrew Stevens (left in top photo), a student at SMRU, has worked for the past three months with Eh Toe Toe and Beh Blue Do, public health interns with the Karen Refugee Committee Education Entity (KRCEE). Supported by a Government of Australia ASIABound short-term mobility grant, their community wide campaign has reached border-area women of childbearing age and their spouses using surveys, focus groups, community consultations and community based organisation (CBO) workshops.

Folic acid is a B-vitamin essential for proper cell growth and development of the embryo. Although essential in tissue formation, there was little awareness of its benefits and role in preventing NTDs among border area populations and local health workers, with only one quarter of SMRU health workers aware of its benefits.

Involving all parts of the community and getting local NGOs and CBOs to include pre-conceptual folate messaging in their work are essential to making the project effective and sustainable, and in getting the folic acid message to pregnant women and their husbands. 

 “The workshops with CBOs were humbling. Once participants understood the problem they were very willing to consider the best ways to disseminate the messaging to the community,” said Dr Rose McGready, SMRU Deputy Director. “The other unexpected response was from the men at outpatients who wanted to take more than one flyer for distribution. They really wanted to help get the word out on folates.”

- Text and pictures by Andrew Steven, Suphak Nosten and Rose McGready

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