Promoting Compliance to Iron and Folic Acid (IFA) Intake in Pregnant Women in Uganda: Prioritizing the Myriad of Factors

Abstract

Objectives: Examine obstacles to the intake of IFA by pregnant women in southwest Uganda Methods: The study employed a combination of methods.  The Logistics Supply Assessment Tool (LSAT) was applied to understand management of essential supplies for anaemia prevention in pregnant women. In addition, routine IFA program data were analyzed and in-depth discussions were held with women attending antenatal care clinics at Itojo and Ibanda hospitals in southwest Uganda Results: The LSAT indicated that the main supplies for anaemia prevention in pregnant women are IFA, albendazole, treated bednets and antimalarials.  There were inefficiencies in logistics management information system and other aspects of supplies management, especially at lower levels of the system, resulting in delayed delivery of supplies to health facilities. In addition, IFA protocols are inconsistently adhered to. While over 75% of pregnant women seeking antenatal services receive IFA, the number of tablets they receive varies widely. Those showing signs of anaemia are prioritized and receive more than 18 tablets while those who are evidently healthy get less than 18. Few women receive counseling about the importance, dosage, and potential side effects of IFA, and less than one-third of women participating in the study knew benefits of IFA or possible side effects. Conclusions: Increasing compliance to IFA intake by pregnant women in Uganda will require improvements in a number of areas, including logistics management information systems, health provider attitudes, prescribing practices and counseling to better inform and motivate women about the importance of taking the complete recommended IFA dosage.