Published: 2021-10-27

Knowledge and consumption of folic acid among teachers in Jammu region: a cross-sectional study

Neha Choudhary, Preeti Manhas, Akash Narangyal, Rohan Singh Manhas


Background: Folic acid reduces the risk of birth defects, including neural tube defects (NTDs). It reduces the risk of miscarriage and fetal death as well as folate-deficiency anemia. Folate status is particularly important before conception and during the first 12 weeks of pregnancy. Objective was to assess knowledge and consumption of folic acid among teachers in the reproductive age group.

Methods: 336 school teachers selected from government and private schools (primary/middle/secondary/higher secondary) by simple random sampling technique. Teacher’s knowledge and consumption of folic acid and associated factors was studied using a pre- tested; self- administered questionnaire.

Results: 95% teachers had heard about folic acid, 57% knew about neural tube defects. 53% were aware of the role of folic acid in NTDs. 66% had knowledge about the best timing for its intake. 56% were aware about the sources rich in folic acid. 75% believed that foods are the best source of folic acid, 80% believed that taking foods rich in folic acid and tablets are sufficient to maintain body stores.49% were taking folic acid presently. 66% of the participants were taking folic acid under medical advice, 29% due to the recommendations by their family/friends while self-initiation was reported in only 5% of the individuals.

Conclusions: IEC activities needs to be conducted among different strata of population so that the intake of folic acid could be increased and associated factors effecting its intake and absorption could be taken care of.


Folate, Folic acid, Neural tube defects

Full Text:



Wallingford JB, Niswander LA, Shaw GM, Finnell RH. The continuing challenge of understanding, preventing, and treating neural tube defects. Science. 2013;339:1222002.

Sharp GF, Naylor LA, Cai J, Hyder ML, Chandra P, Guillory VJ. Assessing awareness, knowledge and use of folic acid in Kansas women between the ages of 18 and 44 years. Matern Child Health J. 2009;13(6):814.

Farley TF, Hambidge SJ, Daley MF. Association of low maternal education with neural tube defects in Colorado, 1989-1998. Public Health. 2002;116:89-94.

Rajab A, Vaishnav A, Freeman NV, Patton MA. Neural tube defects and congenital hydrocephalus in the Sultanate of Oman. J Trop Pediatr. 1998;44:300-3.

World Health Organization. Global health estimates (GHE)- Cause specific mortality. 2015. Available at: _disease/estimates/en/. Accessed on 14 April 2015.

World Health Organization. Global health estimates (GHE)- Disease burden. 2015. Available at Accessed on 14 April 2015.

Krishnaswamy K, Madhavan Nair K. Importance of folate in human nutrition. Br J Nutr. 2001;85:S115-24.

Toriello HV. Professional Practice and Guidelines Committee, American College of Medical Genetics. Folic acid and neural tube defects. Genet Med. 2005;7:283-4.

Ren A. The prevention of neural tube defects with folic acid. World J Clin Pediatr. 2015;4:414.

Unusan N. Folic acid: protection against neural tube defects. In: Engels JV, ed. Focus on birth defects research. New York, NY: Nova Science Publisher; 2006:223-232.

Kurtzweil P. How folate can help prevent birth defects. Department of Health and Human Services, Public Health Service, Food and Drug Administration; 1996.

Perry CA, Renna SA, Khitun E, Ortiz M, Moriarty DJ, Caudill MA. Ethnicity and race influence the folate status response to controlled folate intakes in young women. J Nutr. 2004;134(7):1786-92.

Lamers Y, MacFarlane AJ, O'Connor DL, Fontaine-Bisson B. Periconceptional intake of folic acid among low-risk women in Canada: summary of a workshop aiming to align prenatal folic acid supplement composition with current expert guidelines. Am J Clin Nutr. 2018;108(6):1357-68.

Perez-Escamilla R. Periconceptional folic acid and neural tube defects: public health issues. Bull Pan Am Health Organ. 1995;29:250-63.

Kilker KP. Is knowing half the battle? An examination of the relationship between folic acid knowledge and awareness and daily supplementation with folic acid among 18 to 24 year old women who are not contemplating pregnancy. Atlanta, GA: Georgia State University. 2007.

Aronsson CA, Vehik K, Yang J, Uusitalo U, Hay K, Joslowski G, et al. Use of dietary supplements in pregnant women in relation to sociodemographic factors–a report from The Environmental Determinants of Diabetes in the Young (TEDDY) study. Public Health Nutr. 2013;16(8):1390-402.

Pouchieu C, Levy R, Faure C, Andreeva VA, Galan P, Hercberg S, et al. Socioeconomic, lifestyle and dietary factors associated with dietary supplement use during pregnancy. PLoS One. 2013;8(8):e70733.

Chacko MR, Anding R, Kozinetz CA, Grover JL, Smith PB. Neural tube defects: knowledge and preconceptional prevention practices in minority young women. Pediatrics. 2003;112(3):536-42.