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Maternal anaemia prevalence in low‐income countries is unacceptably high. Our research explored the individual‐, family‐ and community‐level factors affecting antenatal care uptake, iron folic acid (IFA) intake and consumption of micronutrient‐rich diets among pregnant women in the plains of Nepal. We discuss how these findings informed the development of a home visit and community mobilisation intervention to reduce anaemia in pregnancy. We used a qualitative methodology informed by the socio‐ecological framework, conducting semi‐structured interviews with recently pregnant women and key informants, and focus group discussions with mothers‐in‐law and fathers. We found that harmful gender norms restricted women's access to nutrient‐rich food, restricted their mobility and access to antenatal care. These norms also restricted fathers' role to that of the provider, as opposed to the caregiver. Pregnant women, mothers‐in‐law and fathers lacked awareness about iron‐rich foods and how to manage the side effects of IFA. Fathers lacked trust in government health facilities affecting access to care and trust in the efficacy of IFA. Our research informed interventions by (1) informing the development of intervention tools and training; (2) informing the intervention focus to engaging mothers‐in‐law and men to enable behaviour change; and (3) demonstrating the need to work in synergy across individual, family and community levels to address power and positionality, gender norms, trust in health services and harmful norms. Participatory groups and home visits will enable the development and implementation of feasible and acceptable strategies to address family and contextual issues generating knowledge and an enabling environment for behaviour change.

This exploratory study investigated salivary concentrations of silicon, calcium, sodium, and phosphorous over a 60-min time period following the use of a calcium sodium phosphosilicate (CSPS)-containing dentifrice. Participants brushed with a dentifrice containing 5% (w/w) or 0% (w/w) CSPS or swilled with a slurry containing 5% (w/w) CSPS/glycerol. Saliva samples were collected before, and 2, 5, 15, and 60 min after, product use and were analysed using inductively coupled plasma optical emission spectroscopy. Intra-oral pH measurements were also taken. Primary analysis was of centrifuged saliva supernatant containing only dissolved material. At most time points, the CSPS-containing dentifrice and slurry generated significantly more salivary silicon than the dentifrice containing 0% CSPS. At 2-15 min after brushing there was significantly more salivary calcium after use of the CSPS-containing dentifrice and slurry, compared with the 0% CSPS dentifrice; a significant reduction, from baseline, in salivary calcium after use of dentifrice containing 0% CSPS; and an increase in salivary sodium after use of dentifrices containing either 5% or 0% CSPS, but no differences between them. Salivary phosphorous concentration decreased significantly with all treatments 2-5 min after use. There were no significant between-treatment differences in intra-oral pH. Products were generally well tolerated. This study establishes that it is possible to measure changes in salivary ionic composition derived through oral retention of CSPS, delivered via a dentifrice.