Skip to content
Research Article Open access CC BY 4.0

Iron-folic Acid Distribution and Consumption through Antenatal Care: Identifying Barriers across Countries

Celeste Sununtnasuk, John Fiedler, Alexis D'Agostino

European Journal of Nutrition & Food Safety · pp. 524–525 · Published 14 Aug 2015

10.9734/EJNFS/2015/20945

Abstract

Objectives: Despite renewed efforts, the prevalence of maternal anemia is unacceptably high in developing countries. Iron-folic acid (IFA) supplementation and coverage through antenatal care (ANC) is persistently low and remains under-resourced and underutilized. In recognition of these barriers, USAID's SPRING Project developed a rapid, initial assessment tool to help identify constraints within ANC programs that inhibit pregnant women from getting and consuming an ideal minimum number of 180 IFA tablets. Methods: The tool identifies four sequential points at which the ANC system might falter: ANC attendance, IFA receipt or purchase, IFA consumption, and compliance with WHO-recommendations for the ideal minimum number of tablets. Twenty-two high-burden countries were analyzed based on secondary analysis of Demographic and Health Survey (DHS) data. Results: Across all countries, 83% of all pregnant women had at least one ANC visit, and 81% of those women received IFA tablets of which 95% consumed at least one tablet. Overall adherence to daily iron supplementation, however, is low. Only 9% of pregnant women consumed 180 or more IFA tablets. Just two countries had more than 30% of women consume 180 or more tablets during pregnancy. Conclusions: Although the tool cannot isolate the direct causes of a system’s faltering performance, it provides an instrument by which policymakers may investigate its shortcomings. Given the significance of the fourth falter point across all countries, potential areas for investigation include the adequacy of IFA tablet supplies and the technical knowledge, practices, and availability of ANC providers.

Cited by 23

Interventions to increase adherence to micronutrient supplementation during pregnancy: a protocol for a systematic review

Filomena Gomes, Gilles Bergeron, Megan W. Bourassa · Annals of the New York Academy of Sciences · 2020

Integrating and coordinating programs for the management of anemia across the life course

Alison Mildon, Daniel Lopez de Romaña, Maria Elena D. Jefferds · Annals of the New York Academy of Sciences · 2023

Effectiveness of programme approaches to improve the coverage of maternal nutrition interventions in South Asia

Sophie Goudet, Zivai Murira, Harriet Torlesse · Maternal & Child Nutrition · 2018

Monitoring and surveillance for multiple micronutrient supplements in pregnancy

Zuguo Mei, Maria Elena Jefferds, Sorrel Namaste · Maternal & Child Nutrition · 2017

Validity of self-reported receipt of iron supplements during pregnancy: implications for coverage measurement

Mufaro Kanyangarara, Joanne Katz, Melinda K. Munos · BMC Pregnancy and Childbirth · 2019

Article metrics

Real usage data collected on this platform.

0

Page views

0

PDF downloads

0

Outbound clicks

23

Citations

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

No views recorded yet.

Traffic sources

Referring site, by host.

No traffic recorded yet.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.